%0 Journal Article
%T Impact of Immunochemotherapy-Related Hepatic Toxicity on the Outcome of HCV-Positive Diffuse Large B-Cell Lymphoma Patients
%A Fouad Abu-Taleb
%A Rasha Haggag
%A Yasser Elnaggar
%A Ahmed Embaby
%J Journal of Cancer Research
%D 2014
%R 10.1155/2014/982080
%X We conducted this prospective study which included 28 de novo CD20-positive DLBCL patients to assess the clinical outcome, treatment response, and hepatic toxicity in DLBCL patients who received rituximab-CHOP as a first line treatment in relation to HCV infection status. We included 7 patients with positive HCV infection (group A) and 21 patients with negative HCV infection (group B). HCV infection was not a significant risk factor for prognosis (1-year event-free survival rates, 71.4% versus 81%, ; overall survival rates, 85.7% versus 90.5%, , for groups A and B, resp.). CR rate was 71.4% (5/7) in group A and 76.2% (16/21) in group B (). Of the 7 patients who were HCV positive, 2 (28.6%) had enzyme flare (grade 2), compared with 1 of the 21 (4.8%) patients who were HCV negative (). Two (28.6%) of the 7 positive HCV infection patients had viral reactivation (1£żlog10£żIU/mL increase in the viral load). No patient required discontinuation of immunochemotherapy owing to hepatotoxicity in either group. In conclusion, HCV infection might not influence the clinical course in DLBCL patients who receive rituximab-CHOP. Close monitoring of hepatic function and viral load is recommended. 1. Introduction The role of HCV infection in lymphomagenesis is related to several mechanisms such as the sustained antigenic stimulation of the B-cell compartment, viral lymphotropism, and viral proteins, chromosomal aberrations, cytokines, and microRNAs [1]. For decades, the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) was the standard regimen for patients with DLBCL, curing about 30% of the patients; no advantage was observed with more intensive combinations [2]. However, the addition of rituximab, a chimeric monoclonal antibody which targets CD20-positive lymphocytes, to the CHOP regimen induces a significantly higher complete-response rate and increased event-free and overall survival in patients with DLBCL. Therefore, rituximab-combined CHOP regimen (R-CHOP) as immunochemotherapy is now considered to be the standard treatment for patients with DLBCL [3]. Although hepatitis B virus (HBV) reactivation is a well-documented and potentially fatal complication that occurs frequently after introduction of rituximab, data on HCV reactivation or liver dysfunction after chemotherapy for NHL especially with rituximab-containing regimen are controversial [4]. In this report, we compare the clinical characteristics, treatment-related toxicity, and outcome of our patients in relation to HCV status. 2. Patients and Methods 2.1. Eligibility This
%U http://www.hindawi.com/journals/jcr/2014/982080/