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<0.001). This score retained prognostic value in the subgroups of patients treated with and without rituximab (P<0.001). The new score performed better than the International Prognostic Index at multivariate analysis and Harrel C-statistic. With the use of three readily available factors (performance status, albumin level and HCV-RNA viral load), the new "HCV Prognostic Score" is able to identify 3 risk categories with different survival, and may be a useful tool to predict the outcome of hepatitis C virus-associated diffuse large B-cell lymphomas. © 2014 Ferrata Storti Foundation.

Outcome prediction of diffuse large B-cell lymphomas associated with hepatitis C virus infection: A study on behalf of the Fondazione Italiana Linfomi / Merli, M.; Visco, C.; Spina, M.; Luminari, S.; Ferretti, V. V.; Gotti, M.; Rattotti, S.; Fiaccadori, V.; Rusconi, C.; Targhetta, C.; Stelitano, C.; Levis, A.; Ambrosetti, A.; Rossi, D.; Rigacci, L.; D'Arco, A. M.; Musto, P.; Chiappella, A.; Baldini, L.; Bonfichi, M.; Arcaini, L.. - In: HAEMATOLOGICA. - ISSN 0390-6078. - 99:3(2014), pp. 489-496. [10.3324/haematol.2013.094318]

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

Luminari S.;
2014

Abstract

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<0.001). This score retained prognostic value in the subgroups of patients treated with and without rituximab (P<0.001). The new score performed better than the International Prognostic Index at multivariate analysis and Harrel C-statistic. With the use of three readily available factors (performance status, albumin level and HCV-RNA viral load), the new "HCV Prognostic Score" is able to identify 3 risk categories with different survival, and may be a useful tool to predict the outcome of hepatitis C virus-associated diffuse large B-cell lymphomas. © 2014 Ferrata Storti Foundation.
2014
99
3
489
496
Outcome prediction of diffuse large B-cell lymphomas associated with hepatitis C virus infection: A study on behalf of the Fondazione Italiana Linfomi / Merli, M.; Visco, C.; Spina, M.; Luminari, S.; Ferretti, V. V.; Gotti, M.; Rattotti, S.; Fiaccadori, V.; Rusconi, C.; Targhetta, C.; Stelitano, C.; Levis, A.; Ambrosetti, A.; Rossi, D.; Rigacci, L.; D'Arco, A. M.; Musto, P.; Chiappella, A.; Baldini, L.; Bonfichi, M.; Arcaini, L.. - In: HAEMATOLOGICA. - ISSN 0390-6078. - 99:3(2014), pp. 489-496. [10.3324/haematol.2013.094318]
Merli, M.; Visco, C.; Spina, M.; Luminari, S.; Ferretti, V. V.; Gotti, M.; Rattotti, S.; Fiaccadori, V.; Rusconi, C.; Targhetta, C.; Stelitano, C.; Levis, A.; Ambrosetti, A.; Rossi, D.; Rigacci, L.; D'Arco, A. M.; Musto, P.; Chiappella, A.; Baldini, L.; Bonfichi, M.; Arcaini, L.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1249586
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