Prognostic impact of hepatitis C virus infection in patients with diffuse large B-cell lymphoma treated with immunochemotherapy in the context of a novel prognostic index

Objective: Patients with hepatitis C virus (HCV) infection have been associated with development of diffuse large B-cell lymphoma (DLBCL), yet its impact on several clinical aspects, including phenotypic characteristics and treatment-related toxicities as well as survival outcome after rituximab-based immunochemotherapy, remains controversial. Methods: To elucidate the characteristics of HCV-positive DLBCL in the context of a new prognostic model, the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI), we retrospectively analyzed DLBCL patients diagnosed and treated with immunochemotherapy at our institute during the last decade. Results: In all, HCV infection was identified in 22 (17.7%) of 124 DLBCL patients. Except for being more likely to present with an advanced stage of disease, patients with HCV infection were phenotypically indistinguishable from HCV-negative cases. Multivariate analysis showed 3 factors independently predicted a dismal overall survival (OS) outcome: lower albumin level (<3. g/dL vs. ≫3. g/dL, p<. 0.001; HR. =. 13.21, 95% CI. =. 2.69-64.98, p=. 0.001), presence of HCV infection (vs. HCV-negative; HR. =. 9.75, 95% CI. =. 1.97-48.34, p=. 0.005), and poor NCCN-IPI risk (high-intermediate or high vs. low-intermediate or low; HR. =. 5.56, 95% CI. =. 1.17-26.55, p=. 0.031). Conclusions: Our study has demonstrated that HCV infection status and low serum albumin level add important prognostic values to the newly proposed NCCN-IPI model for patients with DLBCL.