Details

Autor(en) / Beteiligte

• Ennishi, Daisuke
• Maeda, Yoshinobu
• Niitsu, Nozomi
• Kojima, Minoru
• Izutsu, Koji
• Takizawa, Jun
• Kusumoto, Shigeru
• Okamoto, Masataka
• Yokoyama, Masahiro
• Takamatsu, Yasushi
• Sunami, Kazutaka
• Miyata, Akira
• Murayama, Kayoko
• Sakai, Akira
• Matsumoto, Morio
• Shinagawa, Katsuji
• Takaki, Akinobu
• Matsuo, Keitaro
• Kinoshita, Tomohiro
• Tanimoto, Mitsune

Titel

Hepatic toxicity and prognosis in hepatitis C virus–infected patients with diffuse large B-cell lymphoma treated with rituximab-containing chemotherapy regimens: a Japanese multicenter analysis

Ist Teil von

• Blood, 2010-12, Vol.116 (24), p.5119-5125

Ort / Verlag

Washington, DC: Elsevier Inc

Erscheinungsjahr

2010

Quelle

MEDLINE

Beschreibungen/Notizen

• The influence of hepatitis C virus (HCV) infection on prognosis and hepatic toxicity in patients with diffuse large B-cell lymphoma in the rituximab era is unclear. Thus, we analyzed 553 patients, 131 of whom were HCV-positive and 422 of whom were HCV-negative, with DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP)–like chemotherapy. Survival outcomes and hepatic toxicity were compared according to HCV infection. The median follow-up was 31 and 32 months for patients who were HCV-positive and HCV-negative, respectively. HCV infection was not a significant risk factor for prognosis (3-year progression-free survival, 69% vs 77%, P = .22; overall survival, 75% vs 84%, P = .07). Of 131 patients who were HCV-positive, 36 (27%) had severe hepatic toxicity (grade 3-4), compared with 13 of 422 (3%) patients who were HCV-negative. Multivariate analysis revealed that HCV infection was a significant risk factor for severe hepatic toxicity (hazard ratio: 14.72; 95% confidence interval, 6.37-34.03; P < .001). An exploratory analysis revealed that pretreatment transaminase was predictive of severe hepatic toxicity. HCV-RNA levels significantly increased during immunochemotherapy (P = .006). These results suggest that careful monitoring of hepatic function and viral load is indicated during immunochemotherapy for HCV-positive patients.