TY - JOUR
T1 - Clinicopathologic characteristics of follicular lymphoma in hepatitis C virus-infected patients
AU - Hosry, Jeff
AU - Miranda, Roberto N.
AU - Samaniego, Felipe
AU - Angelidakis, Georgios
AU - Torres, Harrys A.
N1 - Funding Information:
H. A. T. has been the principal investigator for research grants from Gilead Sciences and Merck & Co., Inc., with all funds paid to MD Anderson. H. A. T. has also been a paid scientific advisor for Gilead Sciences, Merck & Co., Inc., and Dynavax Technologies. The terms of these arrangements are being managed by MD Anderson in accordance with its conflict of interest policies. The other authors declare no competing financial interests.
Funding Information:
We thank Stephanie Deming from the Department of Scientific Publications at MD Anderson for editorial assistance. This study was supported by the NIH/NCI under award number P30CA016672.
Publisher Copyright:
© 2020 John Wiley & Sons Ltd
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Follicular lymphoma (FL) is the most common subtype of indolent non-Hodgkin lymphoma. It has been hypothesized that chronic hepatitis C virus (HCV) infection stimulates IGH-BCL2 clone proliferation, leading to development of FL. Furthermore, regression of FL after antiviral treatment without chemotherapy has been reported in HCV-infected patients. To clarify the relationship between HCV and FL, we compared the prevalence of IGH-BCL2 translocation and other clinicopathologic characteristics between HCV-infected and HCV-uninfected FL patients and determined the impact of HCV eradication on the oncologic outcomes of HCV-infected FL patients. The study included HCV-infected patients (cases) with FL seen at our institution during 2004-2018. Cases were matched with HCV-uninfected FL patients (controls) according to year of lymphoma diagnosis, sex, and hepatitis B serology. We studied 19 cases and 57 controls. More cases than controls had splenic involvement of FL (26% vs 5%, P = 0.02), higher histologic grade (grade 3 in 56% vs 24%, P = 0.01), absent or weak CD10 expression (42% vs 11%, P = 0.005), and absent BCL2 expression (33% vs 4%, P = 0.004). Compared to controls, cases had a lower rate of detection of IGH-BCL2 translocation (31% vs 68%, P = 0.02). Finally, cases with a sustained virologic response (virologic cure of HCV) had a better 10-year overall survival rate than did cases not treated with antivirals or controls (P = 0.001). In conclusion, HCV-infected patients with FL have unique clinicopathologic characteristics including improved overall survival with HCV eradication. The pathogenesis of FL in HCV-infected patients seems unrelated to antiapoptotic effect of IGH-BCL2 rearrangement.
AB - Follicular lymphoma (FL) is the most common subtype of indolent non-Hodgkin lymphoma. It has been hypothesized that chronic hepatitis C virus (HCV) infection stimulates IGH-BCL2 clone proliferation, leading to development of FL. Furthermore, regression of FL after antiviral treatment without chemotherapy has been reported in HCV-infected patients. To clarify the relationship between HCV and FL, we compared the prevalence of IGH-BCL2 translocation and other clinicopathologic characteristics between HCV-infected and HCV-uninfected FL patients and determined the impact of HCV eradication on the oncologic outcomes of HCV-infected FL patients. The study included HCV-infected patients (cases) with FL seen at our institution during 2004-2018. Cases were matched with HCV-uninfected FL patients (controls) according to year of lymphoma diagnosis, sex, and hepatitis B serology. We studied 19 cases and 57 controls. More cases than controls had splenic involvement of FL (26% vs 5%, P = 0.02), higher histologic grade (grade 3 in 56% vs 24%, P = 0.01), absent or weak CD10 expression (42% vs 11%, P = 0.005), and absent BCL2 expression (33% vs 4%, P = 0.004). Compared to controls, cases had a lower rate of detection of IGH-BCL2 translocation (31% vs 68%, P = 0.02). Finally, cases with a sustained virologic response (virologic cure of HCV) had a better 10-year overall survival rate than did cases not treated with antivirals or controls (P = 0.001). In conclusion, HCV-infected patients with FL have unique clinicopathologic characteristics including improved overall survival with HCV eradication. The pathogenesis of FL in HCV-infected patients seems unrelated to antiapoptotic effect of IGH-BCL2 rearrangement.
KW - IGH-BCL2 translocation
KW - clinicopathologic characteristics
KW - follicular lymphoma
KW - hepatitis C virus
KW - overall survival
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U2 - 10.1002/hon.2731
DO - 10.1002/hon.2731
M3 - Article
C2 - 32196714
AN - SCOPUS:85082585412
SN - 0278-0232
VL - 38
SP - 301
EP - 308
JO - Hematological Oncology
JF - Hematological Oncology
IS - 3
ER -