Clearance of Hepatitis C Virus (HCV) Is Associated With Improved Outcomes in HCV-Associated Lymphoma.
Clearance of Hepatitis C Virus (HCV) Is Associated With Improved Outcomes in HCV-Associated Lymphoma.
- 2021
BACKGROUND: Improved hepatitis C virus (HCV) clearance due to directly acting antiviral agents has led to remarkably improved outcomes of indolent HCV-associated non-Hodgkin lymphoma (NHL). The impact of directly acting antivirals on the outcomes of aggressive NHL is still under investigation. Characteristics of HCV-associated NHL in black patients are not well characterized. We report outcomes of HCV-associated NHL compared to their HCV-negative counterparts in a predominantly black population. CONCLUSION: HCV clearance is positively associated with lymphoma outcomes in black patients. Patients who clear HCV have noninferior outcomes to HCV- patients, while those who fail to clear HCV have significantly worse outcomes. Copyright (c) 2020 Elsevier Inc. All rights reserved. PATIENTS AND METHODS: Patients with lymphoma between January 2007 and December 2017 were retrospectively studied. Depending on presence or absence of HCV RNA, patients were grouped into HCV positive (HCV+) and HCV negative (HCV-) cohorts. Depending on virologic clearance (VC), HCV+ were classified into HCV+ with VC and HCV+ without VC. Overall response rate (ORR), complete response, overall survival (OS), and progression-free survival (PFS) of HCV+ patients with and without VC were compared to HCV- patients. RESULTS: Of 397 patients with lymphoma, 40 had HCV. Black comprised 90% of HCV+ patients. Diffuse large B-cell lymphoma was most frequent (47%) in the HCV+ group. HCV+ patients without VC had significantly worse OS and PFS compared to HCV- patients. There were no differences in ORR, complete response, PFS, and OS of HCV+ patients with VC and HCV- patients. These results were consistent in subgroups of diffuse large B-cell lymphoma and aggressive lymphoma.
English
2152-2669
10.1016/j.clml.2020.09.011 [doi] S2152-2650(20)30549-8 [pii]
*Antiviral Agents/tu [Therapeutic Use]
*Hepacivirus/ip [Isolation & Purification]
*Hepatitis C/dt [Drug Therapy]
*Lymphoma, Non-Hodgkin/mo [Mortality]
Adolescent
Adult
Aged
Aged, 80 and over
Female
Hepacivirus/ge [Genetics]
Hepatitis C/vi [Virology]
Humans
Lymphoma, Non-Hodgkin/th [Therapy]
Lymphoma, Non-Hodgkin/vi [Virology]
Male
Middle Aged
Progression-Free Survival
Retrospective Studies
RNA, Viral/ip [Isolation & Purification]
Young Adult
MedStar Health Research Institute
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Washington Cancer Institute
Washington Cancer Institute H
Medicine/Infectious Diseases
Medicine/Internal Medicine
Journal Article
BACKGROUND: Improved hepatitis C virus (HCV) clearance due to directly acting antiviral agents has led to remarkably improved outcomes of indolent HCV-associated non-Hodgkin lymphoma (NHL). The impact of directly acting antivirals on the outcomes of aggressive NHL is still under investigation. Characteristics of HCV-associated NHL in black patients are not well characterized. We report outcomes of HCV-associated NHL compared to their HCV-negative counterparts in a predominantly black population. CONCLUSION: HCV clearance is positively associated with lymphoma outcomes in black patients. Patients who clear HCV have noninferior outcomes to HCV- patients, while those who fail to clear HCV have significantly worse outcomes. Copyright (c) 2020 Elsevier Inc. All rights reserved. PATIENTS AND METHODS: Patients with lymphoma between January 2007 and December 2017 were retrospectively studied. Depending on presence or absence of HCV RNA, patients were grouped into HCV positive (HCV+) and HCV negative (HCV-) cohorts. Depending on virologic clearance (VC), HCV+ were classified into HCV+ with VC and HCV+ without VC. Overall response rate (ORR), complete response, overall survival (OS), and progression-free survival (PFS) of HCV+ patients with and without VC were compared to HCV- patients. RESULTS: Of 397 patients with lymphoma, 40 had HCV. Black comprised 90% of HCV+ patients. Diffuse large B-cell lymphoma was most frequent (47%) in the HCV+ group. HCV+ patients without VC had significantly worse OS and PFS compared to HCV- patients. There were no differences in ORR, complete response, PFS, and OS of HCV+ patients with VC and HCV- patients. These results were consistent in subgroups of diffuse large B-cell lymphoma and aggressive lymphoma.
English
2152-2669
10.1016/j.clml.2020.09.011 [doi] S2152-2650(20)30549-8 [pii]
*Antiviral Agents/tu [Therapeutic Use]
*Hepacivirus/ip [Isolation & Purification]
*Hepatitis C/dt [Drug Therapy]
*Lymphoma, Non-Hodgkin/mo [Mortality]
Adolescent
Adult
Aged
Aged, 80 and over
Female
Hepacivirus/ge [Genetics]
Hepatitis C/vi [Virology]
Humans
Lymphoma, Non-Hodgkin/th [Therapy]
Lymphoma, Non-Hodgkin/vi [Virology]
Male
Middle Aged
Progression-Free Survival
Retrospective Studies
RNA, Viral/ip [Isolation & Purification]
Young Adult
MedStar Health Research Institute
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Washington Cancer Institute
Washington Cancer Institute H
Medicine/Infectious Diseases
Medicine/Internal Medicine
Journal Article