Open AccessHCV infection, B-cell non-Hodgkin’s lymphoma and immunochemotherapy: Evidence and open questions
Author(s) -
Maria Christina Cox,
Maria Antonietta AloeSpiriti,
Elena Cavalieri,
Eleonora Alma,
Elia Gigante,
Paola Begini,
Caterina Rebecchini,
Gianfranco Delle Fave,
Massimo Marignani
Publication year - 2012
Publication title -
world journal of gastrointestinal oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.924
H-Index - 26
ISSN - 1948-5204
DOI - 10.4251/wjgo.v4.i3.46
Subject(s) - medicine , hepatitis c virus , lymphoma , rituximab , hematopoietic stem cell transplantation , hepatitis c , non hodgkin's lymphoma , adverse effect , chemotherapy , gastroenterology , disease , oncology , immunology , virus
There is plenty of data confirming that hepatitis C virus (HCV) infection is a predisposing factor for a B-cell non-Hodgkin's lymphoma (B-NHL) outbreak, while relatively few reports have addressed the role of HCV in affecting B-NHL patients' outcome. HCV infection may influence the short-term outcome of B-NHL because of the emergence of severe hepatic toxicity (HT) during immunochemotherapy. Furthermore, the long term outcome of HCV-related liver disease and patients' quality of life will possibly be affected by Rituximab maintenance, multiple-lines of toxicity during chemotherapy and hematopoietic stem cell transplantation. In this review, data dealing with aggressive and low-grade B-NHL were separately analyzed. The few retrospective papers reporting on aggressive B-NHL patients showed that HCV infection is a risk factor for the outbreak of severe HT during treatment. This adverse event not infrequently leads to the reduction of treatment density and intensity. Existing papers report that low-grade B-NHL patients with HCV infection may have a more widespread disease, more frequent relapses or a lower ORR compared to HCV-negative patients. Notwithstanding that, there is no statistical evidence that the prognosis of HCV-positive patients is inferior to that of HCV-negative subjects. HCV-positive prospective studies and longer follow-up are necessary to ascertain if HCV-positive B-NHL patients have inferior outcomes and if there are long term sequels of immunochemotherapies on the progression of liver disease.