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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.

Authors :
Merli M
Visco C
Spina M
Luminari S
Ferretti VV
Gotti M
Rattotti S
Fiaccadori V
Rusconi C
Targhetta C
Stelitano C
Levis A
Ambrosetti A
Rossi D
Rigacci L
D'Arco AM
Musto P
Chiappella A
Baldini L
Bonfichi M
Arcaini L
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.

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