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Outcome prediction of diffuse large B-cell lymphomas associated with hepatitis C virus infection: a study on behalf of the Fondazione Italiana Linfomi.
- Source :
-
Haematologica [Haematologica] 2014 Mar; Vol. 99 (3), pp. 489-96. Date of Electronic Publication: 2013 Nov 22. - Publication Year :
- 2014
-
Abstract
- A specific prognostication score for hepatitis C virus-positive diffuse large B-cell lymphomas is not available. For this purpose, the Fondazione Italiana Linfomi (FIL, Italian Lymphoma Foundation) carried out a multicenter retrospective study on a large consecutive series of patients with hepatitis C virus-associated diffuse large B-cell lymphoma to evaluate the prognostic impact of clinical and virological features and to develop a specific prognostic score for this subset of patients. All prognostic evaluations were performed on 535 patients treated with an anthracycline-based induction regimen (with rituximab in 255 cases). Severe hepatotoxicity was observed in 14% of patients. The use of rituximab was not associated with increased rate of severe hepatotoxicity. Three-year overall survival and progression-free survival were 71% and 55%, respectively. At multivariate analysis, ECOG performance status of 2 or over, serum albumin below 3.5 g/dL and HCV-RNA viral load over 1000 KIU/mL retained prognostic significance. We combined these 3 factors in a new "HCV Prognostic Score" able to discriminate 3 risk categories with different overall and progression-free survival (low=0; intermediate=1; high-risk ≥2 factors; P<0.001). This score retained prognostic value in the subgroups of patients treated with and without rituximab (P<0.001). The new score performed better than the International Prognostic Index at multivariate analysis and Harrel C-statistic. With the use of three readily available factors (performance status, albumin level and HCV-RNA viral load), the new "HCV Prognostic Score" is able to identify 3 risk categories with different survival, and may be a useful tool to predict the outcome of hepatitis C virus-associated diffuse large B-cell lymphomas.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols adverse effects
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Combined Modality Therapy
Female
Hepatitis C virology
Humans
Lymphoma, Large B-Cell, Diffuse diagnosis
Lymphoma, Large B-Cell, Diffuse drug therapy
Male
Middle Aged
Neoplasm Metastasis
Neoplasm Staging
Patient Outcome Assessment
Prognosis
Retrospective Studies
Treatment Outcome
Young Adult
Hepatitis C complications
Lymphoma, Large B-Cell, Diffuse complications
Lymphoma, Large B-Cell, Diffuse mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1592-8721
- Volume :
- 99
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Haematologica
- Publication Type :
- Academic Journal
- Accession number :
- 24270404
- Full Text :
- https://doi.org/10.3324/haematol.2013.094318