scholarly journals Poor Prognosis of Diffuse Large B-Cell Lymphoma with Hepatitis C Infection

2021 ◽  
Vol 11 (9) ◽  
pp. 844
Author(s):  
Yu-Fen Tsai ◽  
Yi-Chang Liu ◽  
Ching-I Yang ◽  
Tzer-Ming Chuang ◽  
Ya-Lun Ke ◽  
...  
Keyword(s):  
Hepatitis C ◽  
B Cell ◽  
Cell Lymphoma ◽  
Performance Status ◽  
Poor Performance ◽  
B Cell Lymphoma ◽  
Liver Involvement ◽  
Poor Performance Status ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Background: Hepatitis C virus (HCV) in diffuse large B-cell lymphoma (DLBCL) is associated with a higher prevalence and distinctive clinical characteristics and outcomes. Methods: A retrospective analysis of adult DLBCL patients from 2011 to 2015 was studied. Results: A total of 206 adult DLBCL were enrolled with 22 (10.7%) HCV-positive patients. Compared to HCV-negative patients, the HCV-positive group had a poor performance status (p = 0.011), lower platelet count (p = 0.029), and higher spleen and liver involvement incidences (liver involvement, p = 0.027, spleen involvement, p = 0.026), and they received fewer cycles of chemotherapy significantly due to morbidity and mortality (p = 0.048). Overall survival was shorter in HCV-positive DLBCL (25.3 months in HCV-positive vs. not reached (NR), p = 0.049). With multivariate analysis, poor performance status (p < 0.001), advanced stage (p < 0.001), less chemotherapy cycles (p < 0.001), and the presence of liver toxicity (p = 0.001) contributed to poor OS in DLBCL. Among HCV-positive DLBCL, the severity of liver fibrosis was the main risk factor related to death. Conclusion: Inferior survival of HCV-positive DLBCL was observed and associated with poor performance status, higher numbers of complications, and intolerance of treatment, leading to fewer therapy. Therefore, anti-HCV therapy, such as direct-acting antiviral agents, might benefit these patients in the future.

Definition, Diagnosis, and Management of Intravascular Large B-Cell Lymphoma: Proposals and Perspectives From an International Consensus Meeting

2007 ◽  
Vol 25 (21) ◽  
pp. 3168-3173 ◽  
Author(s):  
Maurilio Ponzoni ◽  
Andrés J.M. Ferreri ◽  
Elías Campo ◽  
Fabio Facchetti ◽  
Luca Mazzucchelli ◽  
...  
Keyword(s):  
B Cell ◽  
Clinical Features ◽  
Cell Lymphoma ◽  
Performance Status ◽  
Poor Performance ◽  
B Cell Lymphoma ◽  
Poor Performance Status ◽  
International Consensus ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Intravascular large B-cell lymphoma (IVLBCL) is a rare form of diffuse LBCL characterized by preferential intravascular growth of malignant lymphocytes, aggressive behavior, and an often fatal course. IVLBCL usually affects elderly patients with poor performance status, elevated lactic dehydrogenase serum levels, anemia, and B symptoms. It displays some differences in clinical presentation among diverse geographical areas, mostly between patients diagnosed in Western countries and Japan. In addition, data from the literature suggest that pathologic diagnostic criteria as well as clinical features of this disease may be broader than described in current classification scheme(s). Under the sponsorship of the International Extranodal Lymphoma Study Group, clinicians and pathologists with interest in IVLBCL, coming from Western and Eastern countries, joined to reach a consensus on defining features as well as to focus on the most urgent unresolved issues in IVLBCL. To this end, a representative group of IVLBCL patients coming from both the aforementioned geographical areas were collectively analyzed. Additional features of IVLBCL were proposed both under clinical and pathologic stand points. At the meeting, it emerged that IVLBCL may have additional histopathologic/cytologic definition criteria with respect to those currently recommended, some clinical features are not randomly distributed worldwide, recent therapeutic approaches, such as anti-CD20–containing regimens, may improve outcome, and kidney, spleen, and liver involvement may show peculiar histopathologic features. Finally, a provisional practical diagnostic approach to hemophagocytosis-associated patients and a proposal for the most useful criteria in the settings of differential diagnosis are included.

scholarly journals The Neutrophil-Lymphocyte Ratio Is a Prognostic Marker in Patients with EBV-Positive Diffuse Large B-Cell Lymphoma

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5047-5047
Author(s):  
Brady E Beltran ◽  
Jose M Malaga ◽  
Julio C Chavez ◽  
Eduardo M. Sotomayor ◽  
Jorge J Castillo
Keyword(s):  
B Cell ◽  
Conflicts Of Interest ◽  
Cell Lymphoma ◽  
Performance Status ◽  
Poor Performance ◽  
B Cell Lymphoma ◽  
Advanced Stage ◽  
Lymphocyte Ratio ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Introduction: Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) is a rare hematologic malignancy with a poor prognosis when treated with current therapies. Clinical factors have been developed to prognosticate survival in EBV-positive DLBCL patients; however, more refined, easy to use and reliable prognostic tools are needed. The neutrophil to lymphocyte ratio (NLR) has been reported prognostic in patients with DLBCL (Troppan et al. BJC 2014). We have investigated the prognostic value of the NLR in the overall survival (OS) of patients with untreated EBV-positive DLBCL. Methods: We included patients with a pathological diagnosis of EBV-positive DLBCL who were diagnosed and treated at our institution between 2001-2014. We excluded cases with primary cutaneous CNS involvement, and patients with >50% incomplete data. IRB approval was obtained prior to research. Pathological samples were reviewed by hematopathologists to confirm the diagnosis. Pertinent clinicopathological data such as age, sex, performance status, LDH levels, stage, extranodal sites of disease, absolute neutrophil and lymphocyte counts were collected through chart review, and are presented using descriptive statistics. The NLR was calculated by dividing the absolute neutrophil by the lymphocyte count, and dichotomized in NLR>=5 and NLR<5. Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. Univariate Cox models were fitted to evaluate hazard ratios (HR) for OS. Results: A total of 46 patients were included in our analysis. The median age was 73 years (range 25-95 years) with male predominance (70%). Poor performance status (ECOG >1) was seen in 25 (58%), elevated LDH levels in 19 (46%), 1+ extranodal site in 24 (57%), and advanced stage (stage 3 and 4) in 23 (53%) of patients. Based on the NLR, 13 patients (39%) had NLR>=5. Patients with NLR >=5 were more likely to present with poor performance (ECOG >1; 85% vs. 15%; p=0.04), elevated LDH levels (69% vs. 31%; p=0.04), advanced stage (III and IV, 69% vs. 31%, p=0.05), and IPI score 3-5 (77% vs.23%; p=0.02). There were no differences in age, sex and number of extranodal sites. NLR>=5 was associated with a worse OS (HR 2.67, 95% CI 1.01-7.01; p=0.047). Conclusion: The NLR appears as a novel and easy to use prognostic factor for OS in patients with untreated EBV-positive DLBCL. Our findings support the need for validation of the NLR in larger retrospective or prospective studies in patients with EBV-positive DLBCL. Figure 1. Figure 1. Disclosures No relevant conflicts of interest to declare.

Primary hepatic or splenic diffuse large B-cell lymphoma and hepatitis C virus infection: a non-fortuitous association?

2000 ◽  
Vol 79 (9) ◽  
pp. 530-532 ◽  
Author(s):  
I. Genvresse ◽  
E. Späth-Schwalbe ◽  
H. Meisel ◽  
O. Kaufmann ◽  
D. H. Krüger ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Hepatitis C Virus Infection ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals Concomitant Treatment of Hepatitis C Virus and Diffuse Large B-Cell Lymphoma with Direct-Acting Antivirals in HIV Coinfection: A Case Report

2019 ◽  
Vol 18 ◽  
pp. 232595821882206
Author(s):  
Alyssa Gallipani ◽  
Agnes Cha ◽  
Leonard Berkowitz ◽  
Anjali Bakshi
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Concomitant Treatment ◽  
Direct Acting Antivirals ◽  
Large B Cell Lymphoma ◽  
Direct Acting ◽  
Large B Cell

This report describes a case of concomitant treatment of advanced diffuse large B-cell lymphoma with chemoimmunotherapy along with direct-acting antivirals for hepatitis C virus in a patient coinfected with HIV. The patient tolerated gemcitabine, dexamethasone, cisplatin, and rituximab and achieved sustained virologic response after treatment with ledipasvir/sofosbuvir.

scholarly journals Lactic acidosis: a unique presentation of diffuse large B-cell lymphoma

2019 ◽  
Vol 12 (10) ◽  
pp. e230277 ◽  
Author(s):  
Turab Jawaid Mohammed ◽  
Rohit Gosain ◽  
Rajeev Sharma ◽  
Pallawi Torka
Keyword(s):  
Lactic Acidosis ◽  
B Cell ◽  
Cell Lymphoma ◽  
Performance Status ◽  
B Cell Lymphoma ◽  
Intrathecal Methotrexate ◽  
Dramatic Improvement ◽  
Metabolic Encephalopathy ◽  
Large B Cell Lymphoma ◽  
Large B Cell

An elderly man in the seventh decade of life was brought to the hospital with worsening mental status. Blood tests revealed anaemia and thrombocytopenia with elevated lactate dehydrogenase and serum lactate levels. CT scan showed bulky thoracic and abdominal lymphadenopathy with splenomegaly. A positron emission tomography scan confirmed the above and in addition, revealed bilateral adrenal involvement. Bone marrow biopsy revealed non-germinal centre B-cell-like (non-GCB)-diffuse large B-cell lymphoma (DLBCL). Prompt treatment with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab with intrathecal methotrexate chemotherapy resulted in a dramatic improvement in the patient’s condition. This vignette serves as a reminder to include aggressive lymphomas like DLBCL in the differential diagnoses of patients presenting with metabolic encephalopathy and lactic acidosis. Our patient was moribund at presentation with poor sensorium and failure to thrive. The dilemma was whether to take an aggressive stand and start chemotherapy urgently or whether to stabilise the patient first and then consider the treatment of DLBCL. We make a case for initiating therapy promptly in such patients irrespective of their performance status.

Direct-acting antivirals in relapsed or refractory hepatitis C virus-associated diffuse large B-cell lymphoma

2020 ◽  
Vol 61 (9) ◽  
pp. 2122-2128 ◽  
Author(s):  
Michele Merli ◽  
Irene Defrancesco ◽  
Carlo Visco ◽  
Caroline Besson ◽  
Alice Di Rocco ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Direct Acting Antivirals ◽  
Large B Cell Lymphoma ◽  
Direct Acting ◽  
Large B Cell
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