TY - JOUR
T1 - Interferon-free antiviral treatment in B-cell lymphoproliferative disorders associated with hepatitis C virus infection
AU - Arcaini, Luca
AU - Besson, Caroline
AU - Frigeni, Marco
AU - Fontaine, Hélène
AU - Goldaniga, Maria
AU - Casato, Milvia
AU - Visentini, Marcella
AU - Torres, Harrys A.
AU - Loustaud-Ratti, Veronique
AU - Peveling-Oberhag, Jan
AU - Fabris, Paolo
AU - Rossotti, Roberto
AU - Zaja, Francesco
AU - Rigacci, Luigi
AU - Rattotti, Sara
AU - Bruno, Raffaele
AU - Merli, Michele
AU - Dorival, Céline
AU - Alric, Laurent
AU - Jaccard, Arnaud
AU - Pol, Stanislas
AU - Carrat, Fabrice
AU - Valeria Ferretti, Virginia
AU - Visco, Carlo
AU - Hermine, Olivier
N1 - Publisher Copyright:
© 2016 by The American Society of Hematology.
PY - 2016/11/24
Y1 - 2016/11/24
N2 - Regression of hepatitis C virus (HCV)-associated lymphoma with interferon (IFN)-based antiviral treatment supports an etiological link between lymphoma and HCV infection. In addition, a favorable impact of antiviral treatment on overall survival of patients with HCV-related lymphoma has been reported. Data on IFN-free regimens combining direct-acting antivirals (DAAs) in HCV-associated lymphoproliferative disorders are scanty. We analyzed the virological and lymphoproliferative disease response (LDR) of 46 patients with indolent B-cell non-Hodgkin lymphomas (NHLs) or chronic lymphocytic leukemia (CLL) and chronic HCV infection treated with DAAs. The histological distribution was 37 marginal zone lymphomas (MZLs), 2 lymphoplasmacytic lymphomas, 2 follicular lymphomas, 4 CLL/small lymphocytic lymphomas (CLL/SLLs), and 1 low-grade NHL not otherwise specified. Thirty-nine patients received a sofosbuvir-based regimen and 7 patients received other DAAs. The median duration of DAA therapy was 12 weeks (range, 6-24 weeks). A sustained virological response at week 12 after finishing DAAs was obtained in 45 patients (98%); the overall LDR rate was 67%, including 12 patients (26%) who achieved a complete response. The LDR rate was 73% among patients with MZL, whereas no response was observed in CLL/SLL patients. Seven patients cleared cryoglobulins out of 15 who were initially positive. After a median follow-up of 8 months, 1-year progression-free and overall survival rates were 75% (95% confidence interval [CI], 51-88] and 98% [95% CI, 86-100], respectively. DAA therapy induces a high LDR rate in HCV-associated indolent lymphomas. These data provide a strong rationale for prospective trials with DAAs in this setting.
AB - Regression of hepatitis C virus (HCV)-associated lymphoma with interferon (IFN)-based antiviral treatment supports an etiological link between lymphoma and HCV infection. In addition, a favorable impact of antiviral treatment on overall survival of patients with HCV-related lymphoma has been reported. Data on IFN-free regimens combining direct-acting antivirals (DAAs) in HCV-associated lymphoproliferative disorders are scanty. We analyzed the virological and lymphoproliferative disease response (LDR) of 46 patients with indolent B-cell non-Hodgkin lymphomas (NHLs) or chronic lymphocytic leukemia (CLL) and chronic HCV infection treated with DAAs. The histological distribution was 37 marginal zone lymphomas (MZLs), 2 lymphoplasmacytic lymphomas, 2 follicular lymphomas, 4 CLL/small lymphocytic lymphomas (CLL/SLLs), and 1 low-grade NHL not otherwise specified. Thirty-nine patients received a sofosbuvir-based regimen and 7 patients received other DAAs. The median duration of DAA therapy was 12 weeks (range, 6-24 weeks). A sustained virological response at week 12 after finishing DAAs was obtained in 45 patients (98%); the overall LDR rate was 67%, including 12 patients (26%) who achieved a complete response. The LDR rate was 73% among patients with MZL, whereas no response was observed in CLL/SLL patients. Seven patients cleared cryoglobulins out of 15 who were initially positive. After a median follow-up of 8 months, 1-year progression-free and overall survival rates were 75% (95% confidence interval [CI], 51-88] and 98% [95% CI, 86-100], respectively. DAA therapy induces a high LDR rate in HCV-associated indolent lymphomas. These data provide a strong rationale for prospective trials with DAAs in this setting.
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U2 - 10.1182/blood-2016-05-714667
DO - 10.1182/blood-2016-05-714667
M3 - Article
C2 - 27605512
AN - SCOPUS:85015085713
SN - 0006-4971
VL - 128
SP - 2527
EP - 2532
JO - Blood
JF - Blood
IS - 21
ER -