Antiviral treatment in patients with indolent B-cell lymphomas associated with HCV infection: a study of the Fondazione Italiana Linfomi

• Published in: Annals of oncology Vol. 25; no. 7; pp. 1404 - 1410
• Main Authors: Arcaini, L., Vallisa, D., Rattotti, S., Ferretti, V.V., Ferreri, A.J.M., Bernuzzi, P., Merli, M., Varettoni, M., Chiappella, A., Ambrosetti, A., Tucci, A., Rusconi, C., Visco, C., Spina, M., Cabras, G., Luminari, S., Tucci, M., Musto, P., Ladetto, M., Merli, F., Stelitano, C., d'Arco, A., Rigacci, L., Levis, A., Rossi, D., Spedini, P., Mancuso, S., Marino, D., Bruno, R., Baldini, L., Pulsoni, A.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-07-2014; Oxford University Press
• Subjects: Antineoplastic agents; Antiviral Agents - therapeutic use; antiviral treatment; Biological and medical sciences; Cohort Studies; Female; HCV; Hematologic and hematopoietic diseases; Hepatitis C - complications; Hepatitis C - drug therapy; Human viral diseases; Humans; indolent lymphoma; Infectious diseases; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, B-Cell - complications; Lymphoma, B-Cell - drug therapy; Male; Medical sciences; Middle Aged; outcome; Pharmacology. Drug treatments; Viral diseases; Viral hepatitis; indolent lymphoma; antiviral treatment; HCV; outcome; Human; Prognosis; Hepatic disease; Malignant hemopathy; B-Lymphocyte; Non Hodgkin lymphoma; Infection; Virus; Treatment; Lymphoproliferative syndrome; Viral disease; Digestive diseases; Antiviral; Flaviviridae; Hepatitis C virus; Indolent lymphoma; Hepacivirus; Cancer; Viral hepatitis C
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdu166

Tumor regression after antiviral therapy (AT) is in favor of an etiological role of hepatitis C virus (HCV) in non-Hodgkin's B-cell lymphomas (NHL).
We carried out a cohort study of 704 consecutive HIV-negative, HCV-positive patients with indolent NHL diagnosed and treated from 1993 to 2009 in 39 centers of the Fondazione Italiana Linfomi; 134 patients were managed with AT for lymphoma control.
For entire cohort, 5-year overall survival (OS) was 78% [95% confidence interval (CI): 74%–82%] and 5-year progression-free survival (PFS) was 48% (95% CI: 44%–53%). In multivariate analysis, the use of AT during the patients’ life had positive impact on OS. Forty-four of the 100 patients treated with first-line AT achieved a complete remission (CR) and 33 a partial response (PR). HCV-RNA clearance was achieved in 80 patients and was related to lymphoma response. At a median follow-up of 3.6 years, 5-year PFS was 63% (95% CI: 50%–73%). CR + PR rate was 85% with AT as second-line treatment.
AT produces HCV-RNA clearance and consequent tumor regression in most patients with HCV-related indolent NHL. AT used at any time is associated with improved OS. Consequently, AT can be considered an option for patients with indolent lymphomas who do not need immediate cytoreductive treatment.