Prognostic impact of hepatitis C virus infection in patients with diffuse large B-cell lymphoma treated with immunochemotherapy in the context of a novel prognostic index. Issue 3 (June 2015)

• Record Type: Journal Article
• Authors: Chen, Yi-Yang; Huang, Cih-En; Liang, Fu-Wen; Lu, Chang-Hsien; Chen, Pin-Tsung; Lee, Kuan-Der; Chen, Chih-Cheng
• Is Part Of: Cancer epidemiology. Volume 39:Issue 3(2015)
• Page Start: 382
• Page End: 387
• Publication Date: 2015-06
• Subjects: Hepatitis C -- NCCN-IPI -- Diffuse large B-cell lymphoma -- Albumin -- Rituximab -- Prognosis; Cancer -- Epidemiology -- Periodicals; Cancer -- Prevention -- Periodicals; Cancer -- Diagnosis -- Periodicals; Carcinogenesis -- Periodicals; 616.994005
• DOI: 10.1016/j.canep.2015.04.004
• Languages: English
• ISSNs: 1877-7821

Abstract

Highlights: HCV(+) & (−) DLBCL patients were phenotypically indistinguishable. HCV status, albumin level, & NCCN-IPI risk group independently predict OS outcome. HCV status adds prognostic value to the NCCN-IPI model for DLBCL patients. Abstract: Objective: Patients with hepatitis C virus (HCV) infection have been associated with development of diffuse large B-cell lymphoma (DLBCL), yet its impact on several clinical aspects, including phenotypic characteristics and treatment-related toxicities as well as survival outcome after rituximab-based immunochemotherapy, remains controversial. Methods: To elucidate the characteristics of HCV-positive DLBCL in the context of a new prognostic model, the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI), we retrospectively analyzed DLBCL patients diagnosed and treated with immunochemotherapy at our institute during the last decade. Results: In all, HCV infection was identified in 22 (17.7%) of 124 DLBCL patients. Except for being more likely to present with an advanced stage of disease, patients with HCV infection were phenotypically indistinguishable from HCV-negative cases. Multivariate analysis showed 3 factors independently predicted a dismal overall survival (OS) outcome: lower albumin level (<3 g/dL vs. ≥3 g/dL, p < 0.001; HR = 13.21, 95% CI = 2.69–64.98, p = 0.001), presence of HCV infection (vs. HCV-negative; HR = 9.75, 95% CI = 1.97–48.34, p = 0.005), and poor NCCN-IPI risk (high-intermediate or high vs. low-intermediate or low; HR = 5.56, 95% CI = 1.17–26.55, p = 0.031). Conclusions: Our study has demonstrated that HCV infection status and low serum albumin level add important prognostic values to the newly proposed NCCN-IPI model for patients with DLBCL.