Annals of Oncology Advance Access published online on June 9, 2006
Annals of Oncology, doi:10.1093/annonc/mdl131
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1 Department of Hematology, Ospedale S. Bortolo, Vicenza, Italy
* To whom correspondence should be addressed. 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.
Received March 21, 2006
Revised May 2, 2006
Accepted May 3, 2006
original article
Distinctive natural history in hepatitis C virus positive diffuse large B-cell lymphoma: analysis of 156 patients from northern Italy
C. Visco 1 *,
L. Arcaini 2,
E. Brusamolino 2,
S. Burcheri 2,
A. Ambrosetti 3,
M. Merli 2,
E. Bonoldi 4,
M. Chilosi 5,
A. Viglio 6,
M. Lazzarino 2,
G. Pizzolo 3,
and
F. Rodeghiero 7
2 Division of Hematology, University of Pavia, Italy
3 Department of Cinical and Experimental Medicine, Section of Hematology, University of Verona, Italy
4 Department of Pathology, Ospedale S. Bortolo, Vicenza, Italy
5 Department of Pathology, University of Verona, Italy
6 Department of Human Pathology, IRCCS Policlinico San Matteo, University of Pavia, Italy
7 Department of Hematology, Vicenza, Italy
C. Visco, E-mail: carlovisco{at}hotmail.com
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