Annals of Oncology Advance Access originally published online on June 9, 2006
Annals of Oncology 2006 17(9):1434-1440; doi:10.1093/annonc/mdl131
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© 2006 European Society for Medical Oncology
hematologic malignancies |
Distinctive natural history in hepatitis C virus positive diffuse large B-cell lymphoma: analysis of 156 patients from northern Italy
1 Department of Hematology, Ospedale S. Bortolo, Vicenza, Italy
2 Department of Pathology, Ospedale S. Bortolo, Vicenza, Italy
3 Department of Cinical and Experimental Medicine, Section of Hematology, University of Verona, Italy
4 Department of Pathology, University of Verona, Italy
5 Division of Hematology, University of Pavia, Italy
6 Department of Human Pathology, IRCCS Policlinico San Matteo, University of Pavia, Italy
*Correspondence to: Dr C. Visco, Divisione di Ematologia, Ospedale S. Bortolo, Via Rodolfi 37, 36100 Vicenza, Italy. Tel: +39-0444-753626; Fax: +39-0444-753922; E-mail: carlovisco{at}hotmail.com
Background: Diffuse large B-cell lymphoma (DLBCL) has been correlated to hepatitis C virus (HCV) infection in few series, but characteristics and outcome of these patients remain undefined.
Patients and methods: We analyzed 156 previously untreated consecutive HCV-positive patients with DLBCL observed between 1994 and 2004 in three major institutions from northern Italy.
Results: Median age at presentation was 63 years and 8% of patients had DLBCL transformed from low-grade lymphomas. Spleen was the most frequently involved extranodal site, followed by liver and stomach. Treatment was delivered with cure-intent in 132 patients, while the remaining 24 patients received monochemotherapy or radiotherapy alone due to old age or seriously impaired hepatic function. Only five patients (4%) had to discontinue chemotherapy due to severe liver function impairment. The addition of rituximab did not seem to affect patients' tolerance to treatment. Five-year overall survival of the entire cohort was 72%, while 5-year progression-free survival (PFS) of the 132 patients treated with cure-intent was 51%. Hepatitis B virus co-infection, advanced Ann Arbor stage and nodal origin of the tumor resulted the strongest adverse prognostic factors.
Conclusions: Patients with HCV-positive DLBCL share distinctive clinical features. Future studies should prospectively evaluate the association between HCV and aggressive lymphomas.
Key words: diffuse large B-cell lymphoma, hepatitis, HCV, HBV, spleen
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