Haematologica (Mar 2014)

Outcome prediction of diffuse large B-cell lymphomas associated with hepatitis C virus infection: a study on behalf of the Fondazione Italiana Linfomi

  • Michele Merli,
  • Carlo Visco,
  • Michele Spina,
  • Stefano Luminari,
  • Virginia Valeria Ferretti,
  • Manuel Gotti,
  • Sara Rattotti,
  • Valeria Fiaccadori,
  • Chiara Rusconi,
  • Clara Targhetta,
  • Caterina Stelitano,
  • Alessandro Levis,
  • Achille Ambrosetti,
  • Davide Rossi,
  • Luigi Rigacci,
  • Alfonso Maria D’Arco,
  • Pellegrino Musto,
  • Annalisa Chiappella,
  • Luca Baldini,
  • Maurizio Bonfichi,
  • Luca Arcaini

DOI
https://doi.org/10.3324/haematol.2013.094318
Journal volume & issue
Vol. 99, no. 3

Abstract

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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