Clearance of Hepatitis C Virus (HCV) Is Associated With Improved Outcomes in HCV-Associated Lymphoma

Sanjal H. Desai, Valentina Baez-Sosa, Rumaisa Hameed, Ghassan Al-Shbool, Stephen Fernandez, Anusha Vakiti, Facundo Stingo, Tripti Adhikari, Emily Paku, Vera Malkovska, Dawn Fishbein

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Improved hepatitis C virus (HCV) clearance due to directly acting antiviral agents has led to remarkably improved outcomes of indolent HCV-associated non-Hodgkin lymphoma (NHL). The impact of directly acting antivirals on the outcomes of aggressive NHL is still under investigation. Characteristics of HCV-associated NHL in black patients are not well characterized. We report outcomes of HCV-associated NHL compared to their HCV-negative counterparts in a predominantly black population. Patients and Methods: Patients with lymphoma between January 2007 and December 2017 were retrospectively studied. Depending on presence or absence of HCV RNA, patients were grouped into HCV positive (HCV+) and HCV negative (HCV) cohorts. Depending on virologic clearance (VC), HCV+ were classified into HCV+ with VC and HCV+ without VC. Overall response rate (ORR), complete response, overall survival (OS), and progression-free survival (PFS) of HCV+ patients with and without VC were compared to HCV patients. Results: Of 397 patients with lymphoma, 40 had HCV. Black comprised 90% of HCV+ patients. Diffuse large B-cell lymphoma was most frequent (47%) in the HCV+ group. HCV+ patients without VC had significantly worse OS and PFS compared to HCV patients. There were no differences in ORR, complete response, PFS, and OS of HCV+ patients with VC and HCV patients. These results were consistent in subgroups of diffuse large B-cell lymphoma and aggressive lymphoma. Conclusion: HCV clearance is positively associated with lymphoma outcomes in black patients. Patients who clear HCV have noninferior outcomes to HCV patients, while those who fail to clear HCV have significantly worse outcomes. We report outcomes of hepatitis C virus (HCV)-associated lymphoma compared to HCV-negative counterparts in a predominantly black population. HCV-negative patients without virologic clearance (VC) had significantly worse survival compared to HCV-negative patients. There were no differences in response rates and survival of HCV-positive patients with VC and HCV-negative patients. These results were consistent in subgroups of diffuse large B-cell lymphoma and aggressive lymphoma.

Original languageEnglish (US)
Pages (from-to)e185-e193
JournalClinical Lymphoma, Myeloma and Leukemia
Volume21
Issue number2
DOIs
StatePublished - Feb 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 Elsevier Inc.

Keywords

  • Black
  • Chemoimmunotherapy
  • Diffuse large B cell lymphoma
  • Directly acting antiviral therapy
  • Non-Hodgkin's lymphoma

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