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Fu L, Yu J, Chen Z, Gao F, Zhang Z, Fu J, Feng W, Hong P, Jin J. Shared genetic factors and causal association between chronic hepatitis C infection and diffuse large B cell lymphoma. Infect Agent Cancer 2024; 19:15. [PMID: 38654358 DOI: 10.1186/s13027-024-00577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Epidemiological research and systematic meta-analyses indicate a higher risk of B-cell lymphomas in patients with chronic hepatitis C virus (HCV) compared to non-infected individuals. However, the genetic links between HCV and these lymphomas remain under-researched. METHODS Mendelian randomization analysis was employed to explore the association between chronic hepatitis C (CHC) and B-cell lymphomas as well as chronic lymphocytic leukemia (CLL). Approximate Bayes Factor (ABF) localization analysis was conducted to find shared genetic variants that might connect CHC with B-cell lymphomas and chronic lymphocytic leukemia (CLL). Furthermore, The Variant Effect Predictor (VEP) was utilized to annotate the functional effects of the identified genetic variants. RESULTS Mendelian randomization revealed a significant association between CHC and increased diffuse large B cell lymphoma (DLBCL) risk (OR: 1.34; 95% CI: 1.01-1.78; P = 0.0397). Subsequent colocalization analysis pinpointed two noteworthy variants, rs17208853 (chr6:32408583) and rs482759 (chr6:32227240) between these two traits. The annotation of these variants through the VEP revealed their respective associations with the butyrophilin-like protein 2 (BTNL2) and notch receptor 4 (NOTCH4) genes, along with the long non-coding RNA (lncRNA) TSBP1-AS1. CONCLUSION This research provides a refined genetic understanding of the CHC-DLBCL connection, opening avenues for targeted therapeutic research and intervention.
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Affiliation(s)
- Leihua Fu
- Department of Hematology, Shaoxing People's Hospital, 312000, Shaoxing City, Zhejiang Province, China.
| | - Jieni Yu
- Department of Hematology, Shaoxing People's Hospital, 312000, Shaoxing City, Zhejiang Province, China
| | - Zhe Chen
- Department of Hematology, Shaoxing People's Hospital, 312000, Shaoxing City, Zhejiang Province, China
| | - Feidan Gao
- Department of Hematology, Shaoxing People's Hospital, 312000, Shaoxing City, Zhejiang Province, China
| | - Zhijian Zhang
- Department of Hematology, Shaoxing People's Hospital, 312000, Shaoxing City, Zhejiang Province, China
| | - Jiaping Fu
- Department of Hematology, Shaoxing People's Hospital, 312000, Shaoxing City, Zhejiang Province, China
| | - Weiying Feng
- Department of Hematology, Shaoxing People's Hospital, 312000, Shaoxing City, Zhejiang Province, China
| | - Pan Hong
- Department of Hematology, Shaoxing People's Hospital, 312000, Shaoxing City, Zhejiang Province, China
| | - Jing Jin
- Department of Hematology, Shaoxing People's Hospital, 312000, Shaoxing City, Zhejiang Province, China
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2
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Rosenberg M, Poluch M, Thomas C, Sindaco P, Khoo A, Porcu P. Hepatitis B Virus and B-cell lymphoma: evidence, unmet need, clinical impact, and opportunities. Front Oncol 2023; 13:1275800. [PMID: 37927464 PMCID: PMC10623156 DOI: 10.3389/fonc.2023.1275800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
Nearly a billion people worldwide are infected with the hepatitis B Virus (HBV) and about a third of them have chronic infection. HBV is an important cause of morbidity and mortality, including acute and chronic hepatitis and hepatocellular carcinoma (HCC). Screening and control of primary HBV infection through vaccination represent a major advance in global public health, but large sections of the world population, in both developed and underdeveloped countries, remain unscreened and unvaccinated. In addition to being a global cause of liver disease, an important role of HBV in lymphoma has also emerged. First, the high risk of HBV reactivation in previously infected patients receiving chemo-immunotherapy necessitates the systematic evaluation of HBV serological status in all non-Hodgkin's lymphoma (NHL) cases and preemptive antiviral therapy for those who may have chronic or occult HBV infection. Second, HBV has been shown to infect lymphocytes, namely B-cells, and has been associated with a higher risk of developing B-cell lymphoma, most clearly in countries where HBV is endemic. While the risk of HBV reactivation with chemoimmunotherapy in NHL is well known, the role and the impact of HBV as a global lymphoma risk factor and potential oncogenic driver in B-cells are very poorly understood. Here, we review the clinical and scientific evidence supporting an association between HBV and B-cell lymphoma, with a particular focus on diffuse large B-cell lymphoma (DLBCL) and provide an overview of the estimated impact of HBV infection on the biology and clinical course of DLBCL. We also discuss ways to gain a better insight into the unmet need posed by HBV in lymphoma and whether assessing immune responses to HBV, measuring viral loads, and detecting the presence of HBV-encoded proteins in tumor tissue could be integrated into the molecular and clinical risk stratification of patients with DLBCL.
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Affiliation(s)
- Maya Rosenberg
- Department of Internal Medicine, New York University Langone Health, New York, NY, United States
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Maria Poluch
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Colin Thomas
- Department of Medical Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States
| | - Paola Sindaco
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Alan Khoo
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States
| | - Pierluigi Porcu
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
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3
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Mazzaro C, Bomben R, Gragnani L, Visentini M, Pozzato G, Pozzo F, Zucchetto A, Gattei V. Hepatitis C virus-associated B-cell lymphomas: The importance of the new direct antiviral agent therapy. Semin Hematol 2022; 59:177-182. [PMID: 36805885 DOI: 10.1053/j.seminhematol.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 11/30/2022]
Abstract
Hepatitis C virus (HCV) is a hepatotropic and lymphotropic virus, responsible for both chronic hepatitis and extra-hepatic manifestations. Multiple epidemiologic, clinical, biological, and molecular studies have suggested that HCV plays a causal role also in the development of several lymphoproliferative disorders, either benign, such as mixed cryoglobulinemia, or malignant, such as B-cell non-Hodgkin lymphomas (NHL). Chronic viral antigenic stimulation of B-lymphocytes plays a fundamental basic role from the onset of lymphoma to its final steps. In the past, several studies demonstrated that the association of pegylated interferon plus ribavirin was able to eradicate HCV, with subsequent regression of indolent B-cell low-grade NHL. Other studies have demonstrated that direct antiviral agents (DAAs) therapy have some efficacy in HCV-associated NHL, particularly in patients with low-grade NHL or marginal zone-lymphoma, but these results need to be confirmed in larger studies with longer follow-up. The response rate of antiviral therapy seems favorable also in high grade NHL when DAAs therapy is administered in combination with chemotherapy and therefore antiviral therapy should be considered as a first-line approach in HCV-related NHL.
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Affiliation(s)
- Cesare Mazzaro
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Pordenone, Italy.
| | - Riccardo Bomben
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Pordenone, Italy
| | - Laura Gragnani
- MASVE Interdepartmental Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy
| | - Marcella Visentini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Gabriele Pozzato
- Clinical and Surgical Sciences, University of Trieste, Trieste, Italy
| | - Federico Pozzo
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Pordenone, Italy
| | - Antonella Zucchetto
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Pordenone, Italy
| | - Valter Gattei
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Pordenone, Italy
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4
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Shabbir A, Kojadinovic A, Gidfar S, Mundi PS. Extranodal Diffuse Large B-Cell Lymphoma of Bone and Soft Tissue Presenting With Marked Lymphedema and Hypercalcemia. Cureus 2022; 14:e22025. [PMID: 35155052 PMCID: PMC8823701 DOI: 10.7759/cureus.22025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 12/02/2022] Open
Abstract
Extranodal involvement is more prevalent in diffuse large B-cell lymphoma (DLBCL) compared to other non-Hodgkin lymphoma subtypes, with up to 40% of patients with early-stage disease having at least one extranodal site. Virtually any tissue can be involved, but primary skeletal muscle and bone DLBCL is exceedingly rare. Here we report a case of DLBCL of the humerus and proximal limb musculature in a Vietnam War combat veteran with significant Agent Orange exposure and untreated hepatitis C infection. The patient presented with 1,25-dihydroxyvitamin D3-mediated malignant hypercalcemia and massive soft tissue infiltration. He had an excellent treatment response to chemotherapy and involved field radiation therapy. Also, we discuss hepatitis C and Agent Orange in the context of the pathogenesis and management of DLBCL.
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Cacoub P, Comarmond C, Vieira M, Régnier P, Saadoun D. HCV-related lymphoproliferative disorders in the direct-acting antiviral era: From mixed cryoglobulinaemia to B-cell lymphoma. J Hepatol 2022; 76:174-185. [PMID: 34600000 DOI: 10.1016/j.jhep.2021.09.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/31/2021] [Accepted: 09/14/2021] [Indexed: 02/06/2023]
Abstract
HCV has been shown to induce many B-cell lymphoproliferative disorders. B lymphocytes specialise in producing immunoglobulins and, during chronic HCV infection, they can cause manifestations ranging from polyclonal hypergammaglobulinaemia without clinical repercussions, through mixed cryoglobulinaemic vasculitis to B-cell non-Hodgkin lymphoma. This spectrum is supported by substantial epidemiological, pathophysiological and therapeutic data. Many, although not all, of the pathogenic pathways leading from one extreme to another have been decrypted. Chronic viral antigen stimulation of B lymphocytes has a central role until the final steps before overt malignancy. This has direct implications for treatment strategies, which always include the use of direct-acting antivirals sometimes alongside immunosuppressants. The role of direct-acting antivirals has been well established in patients with cryoglobulinaemia vasculitis. However, their positive impact on B-cell non-Hodgkin lymphoma needs to be confirmed in larger studies with longer follow-up.
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Affiliation(s)
- Patrice Cacoub
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France; Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose inflammatoire, F-75013, Paris, France; Institut National de la Santé et de la Recherche Médicale, INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; Sorbonne Université, UPMC Univ Paris 06, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), F-75005, Paris, France.
| | - Cloé Comarmond
- AP-HP, Lariboisière Hospital, Department of Internal Medicine and Clinical Immunology, Paris, France
| | - Matheus Vieira
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France; Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose inflammatoire, F-75013, Paris, France; Institut National de la Santé et de la Recherche Médicale, INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; Sorbonne Université, UPMC Univ Paris 06, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), F-75005, Paris, France
| | - Paul Régnier
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France; Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose inflammatoire, F-75013, Paris, France; Institut National de la Santé et de la Recherche Médicale, INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; Sorbonne Université, UPMC Univ Paris 06, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), F-75005, Paris, France
| | - David Saadoun
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France; Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose inflammatoire, F-75013, Paris, France; Institut National de la Santé et de la Recherche Médicale, INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; Sorbonne Université, UPMC Univ Paris 06, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), F-75005, Paris, France
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6
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Mert D, Merdin A, Ceken S, Dal MS, Ertek M, Altuntas F. Evaluation of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus seroprevalence in patients with diffuse large B cell lymphoma and Hodgkin's lymphoma. J Cancer Res Ther 2021; 17:951-955. [PMID: 34528547 DOI: 10.4103/jcrt.jcrt_465_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Backgrounds Non-Hodgkin's lymphoma and Hodgkin's lymphomas (HL) are lymphoid neoplasms. Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) are viruses that could proliferate in lymphoid tissues. These viruses may cause lymphoproliferative diseases. The aim of this study was to evaluate the seroprevalence of HBV, HCV, and HIV in patients with diffuse large B-cell lymphoma (DLBCL) and HL, to compare the relationship between these two disease groups and to determine the relationship between the three viruses and their characteristics. Materials and Methods The study was a retrospective study. Patients who were followed up in hematology and hepatitis outpatient units between January 01, 2012, and May 01, 2019, were included in the study. Results A statistically significant relationship was observed between the disease groups in terms of hepatitis B surface antigen (HBsAg), hepatitis B core (HBc) IgG antibody, hepatitis B e antigen (HBeAg), and anti-HBe seropositivities (P = 0.004, P = 0.006, P = 0.041, and P = 0.014, respectively). There was also a statistically significant relationship between the disease groups in terms of anti-HCV seropositivity (P = 0.029). HBsAg, anti-HBc IgG, HBeAg, anti-Hbe, and HCV seropositivity rates were higher in patients with DLBCL than in patients with HL. Conclusion These findings suggest that there may be a relationship between hepatitis viruses and DLBCL. Evaluation of HBV and HCV infections in these patients before starting treatment is thought to be beneficial in initiating antiviral prophylaxis to prevent reactivation in seropositive cases. In addition, care should be taken for the development of lymphoma in the follow-up of HCV and HBV infections.
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Affiliation(s)
- Duygu Mert
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Alparslan Merdin
- University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
| | - Sabahat Ceken
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Mehmet Sinan Dal
- University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
| | - Mustafa Ertek
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Fevzi Altuntas
- University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
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7
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Affiliation(s)
- Patrice Cacoub
- From the Department of Internal Medicine and Clinical Immunology, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Centre de Référence des Maladies Auto-Immunes Systémiques Rares and Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose Inflammatoire, Institut National de la Santé et de la Recherche Médicale UMR S 959, Centre National de la Recherche Scientifique FRE3632, and the Inflammation-Immunopathology-Biotherapy Department, Sorbonne Université - all in Paris
| | - David Saadoun
- From the Department of Internal Medicine and Clinical Immunology, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Centre de Référence des Maladies Auto-Immunes Systémiques Rares and Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose Inflammatoire, Institut National de la Santé et de la Recherche Médicale UMR S 959, Centre National de la Recherche Scientifique FRE3632, and the Inflammation-Immunopathology-Biotherapy Department, Sorbonne Université - all in Paris
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8
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Zhang XY, Wang ZM. Relevance on the diagnosis of malignant lymphoma of the salivary gland. World J Clin Cases 2020; 8:2717-2726. [PMID: 32742982 PMCID: PMC7360714 DOI: 10.12998/wjcc.v8.i13.2717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/13/2020] [Accepted: 06/10/2020] [Indexed: 02/05/2023] Open
Abstract
Malignant lymphoma originates from the lymphohematopoietic system. It can occur in any lymphoid tissue. Malignant lymphoma of the salivary gland is rare, but its incidence has increased in recent years. Its clinical- presentations are non-specific, and it is often manifested as a painless mass in a salivary gland, which can be accompanied by multiple swollen cervical lymph nodes. Confirmation of the diagnosis before an invasive procedure is difficult. Clinically, malignant lymphoma of the salivary gland tends to be misdiagnosed, leading to an inappropriate treatment plan and the ultimate delay in the optimal treatment of the disease. This article reviews the pathogenesis, clinical features, imaging findings, diagnosis, treatment and prognosis of malignant lymphoma of the salivary gland.
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Affiliation(s)
- Xin-Yue Zhang
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Zhi-Ming Wang
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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9
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Hosry J, Miranda RN, Samaniego F, Angelidakis G, Torres HA. Clinicopathologic characteristics of follicular lymphoma in hepatitis C virus-infected patients. Hematol Oncol 2020; 38:301-308. [PMID: 32196714 DOI: 10.1002/hon.2731] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 02/10/2020] [Accepted: 03/09/2020] [Indexed: 12/19/2022]
Abstract
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.
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Affiliation(s)
- Jeff Hosry
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Felipe Samaniego
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Georgios Angelidakis
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Harrys A Torres
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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10
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Travaglino A, Varricchio S, Pace M, Iuliano A, Picardi M, Tranfa F, Staibano S, Mascolo M. Hepatitis C virus in MALT-lymphoma of the ocular adnexa. Pathol Res Pract 2020; 216:152864. [PMID: 32088088 DOI: 10.1016/j.prp.2020.152864] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/31/2020] [Accepted: 02/10/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Hepatitis C virus (HCV) has been proposed as a possible etiologic factor in ocular adnexal marginal zone lymphoma (OAML). We aimed to assess the prevalence of HCV infection in patients with OAML through a systematic review and meta-analysis. METHODS Electronic databases were searched from their inception to August 2019 for studies assessing HCV seroprevalence in patients with OAML. Pooled prevalence of HCV infection was calculated with 95 % confidence interval (CI). Statistical heterogeneity among studies was quantified via the inconsistency index (I2). Funnel plot symmetry was used to assess the risk of bias across studies. RESULTS Nine studies with 360 patients were included. Overall pooled prevalence of HCV in OAML was 12.7 %, with low statistical heterogeneity (I2 = 17.4 %) and with asymmetrical funnel plot. The studies clustered into two groups: 5 studies (3 from Italy and 2 multicenter with a major Italian contribution) showed a higher HCV prevalence in OAML (15.6 %), while the other 4 (from countries other than Italy) showed a lower prevalence (4.7 %); in both subgroups, statistical heterogeneity was null (I2 = 0%) and funnel plot was symmetrical. CONCLUSION HCV might be a significant etiologic factor of OAML in Italy.
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Affiliation(s)
- Antonio Travaglino
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Naples, Italy
| | - Silvia Varricchio
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Naples, Italy
| | - Mirella Pace
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Naples, Italy
| | - Adriana Iuliano
- Department of Neuroscience, Reproductive Sciences and Dentistry, Ophthalmology Section, Federico II University of Naples, Naples, Italy
| | - Marco Picardi
- Department of Clinical Medicine and Surgery, Hematology Section, Federico II University of Naples, Naples, Italy
| | - Fausto Tranfa
- Department of Neuroscience, Reproductive Sciences and Dentistry, Ophthalmology Section, Federico II University of Naples, Naples, Italy
| | - Stefania Staibano
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Naples, Italy
| | - Massimo Mascolo
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Naples, Italy.
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11
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Ferri C, Feld JJ, Bondin M, Cacoub P. Expert opinion on managing chronic HCV in patients with non-Hodgkin lymphoma and other extrahepatic malignancies. Antivir Ther 2019; 23:23-33. [PMID: 30451149 DOI: 10.3851/imp3250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2018] [Indexed: 02/07/2023]
Abstract
HCV is a carcinogen that is well established as a major risk factor for hepatocellular carcinoma. Evidence that HCV plays a role in the development of extrahepatic malignancies is less robust; however, epidemiological studies have consistently demonstrated an association between HCV infection and B-cell non-Hodgkin lymphoma (NHL). The strongest evidence for a link between HCV and tumourigenesis is the clear association between viral eradication, as indicated by achievement of sustained virological response, and remission of B-cell NHL. All-oral direct-acting antiviral-based therapies are effective in patients with HCV-associated NHL and well tolerated. For this reason, it is important that clinicians assess HCV-infected patients for HCV-associated extrahepatic malignancies so patients can receive timely diagnosis and treatment.
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Affiliation(s)
| | - Jordan J Feld
- Toronto Centre for Liver Disease, Toronto General Hospital, University of Toronto, Toronto, ON, Canada
| | | | - Patrice Cacoub
- Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France.,INSERM, UMR_S 959, F-75013, Paris, France.,CNRS, FRE3632, F-75005, Paris, France.,AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, F-75013, Paris, France
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12
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Merli M, Frigeni M, Alric L, Visco C, Besson C, Mannelli L, Di Rocco A, Ferrari A, Farina L, Pirisi M, Piazza F, Loustaud-Ratti V, Arcari A, Marino D, Sica A, Goldaniga M, Rusconi C, Gentile M, Cencini E, Benanti F, Rumi MG, Ferretti VV, Grossi P, Gotti M, Sciarra R, Tisi MC, Cano I, Zuccaro V, Passamonti F, Arcaini L. Direct-Acting Antivirals in Hepatitis C Virus-Associated Diffuse Large B-cell Lymphomas. Oncologist 2019; 24:e720-e729. [PMID: 30552159 PMCID: PMC6693710 DOI: 10.1634/theoncologist.2018-0331] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 11/06/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND International guidelines suggest hepatitis C virus (HCV) eradication by direct-acting antivirals (DAAs) after first-line immunochemotherapy (I-CT) in patients with HCV-positive diffuse large B-cell lymphoma (DLBCL), although limited experiences substantiate this recommendation. Moreover, only a few data concerning concurrent administration of DAAs with I-CT have been reported. SUBJECTS, MATERIALS, AND METHODS We analyzed hematological and virological outcome and survival of 47 consecutive patients with HCV-positive DLBCL treated at 23 Italian and French centers with DAAs either concurrently (concurrent cohort [ConC]: n = 9) or subsequently (sequential cohort [SeqC]: n = 38) to first-line I-CT (mainly rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone [R-CHOP]-like). RESULTS Median age was 61 years, 89% of patients had stage III/IV, and 25% presented evidence of cirrhosis. Genotype was 1 in 56% and 2 in 34% of cases. Overall, 46 of 47 patients obtained complete response to I-CT. All patients received appropriate DAAs according to genotype, mainly sofosbuvir-based regimens (n = 45). Overall, 45 patients (96%) achieved sustained virological response, 8 of 9 in ConC and 37 of 38 in SeqC. DAAs were well tolerated, with only 11 patients experiencing grade 1-2 adverse events. Twenty-three patients experienced hepatic toxicity (grade 3-4 in seven) following I-CT in SeqC, compared to only one patient in ConC. At a median follow-up of 2.8 years, two patients died (2-year overall survival, 97.4%) and three progressed (2-year progression-free survival, 93.1%). CONCLUSION Excellent outcome of this cohort of HCV-positive DLBCL suggests benefit of HCV eradication by DAAs either after or during I-CT. Moreover, concurrent DAAs and R-CHOP administration appeared feasible, effective, and ideally preferable to deferred administration of DAAs for the prevention of hepatic toxicity. IMPLICATIONS FOR PRACTICE Hepatitis C virus (HCV)-associated diffuse large B-cell lymphomas (DLBCLs) represent a great therapeutic challenge, especially in terms of hepatic toxicity during immune-chemotherapy (I-CT) and long-term hepatic complications. The advent of highly effective and toxicity-free direct-acting antivirals (DAAs) created an exciting opportunity to easily eradicate HCV shortly after or in concomitance with first-line immunochemotherapy (usually R-CHOP). This retrospective international study reports the real-life use of the combination of these two therapeutic modalities either in the concurrent or sequential approach (DAAs after I-CT) in 47 patients. The favorable reported results on long-term outcome seem to support the eradication of HCV with DAAs in all patients with HCV-positive DLBCL. Moreover, the results from the concurrent approach were effective and safe and displayed an advantage in preventing hepatic toxicity during I-CT.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antiviral Agents/therapeutic use
- Cyclophosphamide/administration & dosage
- Disease-Free Survival
- Doxorubicin/administration & dosage
- Female
- Hepacivirus/drug effects
- Hepatitis C, Chronic/drug therapy
- Hepatitis C, Chronic/epidemiology
- Hepatitis C, Chronic/pathology
- Hepatitis C, Chronic/virology
- Humans
- Incidence
- Italy/epidemiology
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Middle Aged
- Prednisone/administration & dosage
- Retrospective Studies
- Rituximab/administration & dosage
- Vincristine/administration & dosage
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Affiliation(s)
- Michele Merli
- Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Marco Frigeni
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Laurent Alric
- Department of Internal Medicine and Digestive Diseases, University Hospital Toulouse, UMR 152 PharmaDev, IRD Toulouse 3 University, France
| | - Carlo Visco
- Cell Therapy and Hematology, Ospedale San Bortolo, Vicenza, Italy
| | - Caroline Besson
- Unit of Hematology-Oncology, Centre Hospitalier de Versailles, Le Chesnay; Université Versailles Saint Quentin en Yvelines; INSERM U1018, Centre pour la Recherche en Epidemiologie et Sante des Populations (CESP), Equipe Generations et Sante, Gustave Roussy, Villejuif, France
| | - Lara Mannelli
- Hematology, Azienda Ospedaliera Careggi, Florence, Italy
| | - Alice Di Rocco
- Cellular Biotechnologies and Hematology, Sapienza University of Rome, Rome, Italy
| | - Angela Ferrari
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Italy
| | - Lucia Farina
- Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Mario Pirisi
- Translational Medicine, University of Piemonte Orientale UPO, Novara, Italy
| | | | - Véronique Loustaud-Ratti
- Hepatology, Centre Hospitalier Universitaire de Limoges, U-1248 INSERM, Université de Limoges, Limoges, France
| | | | - Dario Marino
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV IRCCS, Padova, Italy
| | - Antonello Sica
- Oncology and Hematology, AOU "Luigi Vanvitelli", Naples, Italy
| | - Maria Goldaniga
- Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Rusconi
- Hematology and Oncology, Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Massimo Gentile
- Onco-Hematology, Hematology Unit, AO of Cosenza, Cosenza, Italy
| | - Emanuele Cencini
- Hematology, Azienda Ospedaliera Senese, University of Siena, Siena, Italy
| | | | - Maria Grazia Rumi
- Hepatology, Ospedale San Giuseppe IRCCS Multimedica, University of Milan, Milan, Italy
| | | | - Paolo Grossi
- Infectious and Tropical Diseases, University Hospital Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Manuel Gotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberta Sciarra
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Isabel Cano
- Hematology Department, Centre Hospitalier de Versailles, Versailles, France
| | - Valentina Zuccaro
- Infectious and Tropical Diseases, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Francesco Passamonti
- Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Luca Arcaini
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Cacoub P, Desbois AC, Comarmond C, Saadoun D. Impact of sustained virological response on the extrahepatic manifestations of chronic hepatitis C: a meta-analysis. Gut 2018; 67:2025-2034. [PMID: 29703790 DOI: 10.1136/gutjnl-2018-316234] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 03/15/2018] [Accepted: 04/05/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Extrahepatic manifestations of HCV are responsible for morbidity and mortality in many chronically infected patients. New, interferon-free antiviral treatment regimens, which present the opportunity to treat all HCV-infected patients, call for a better understanding of the benefits of treating non-cirrhotic chronically infected individuals. METHODS A systematic review was conducted. Identified studies from targeted database searches on Embase and Medline were screened. The methodological quality of the included publications was evaluated. Random-effect model meta-analyses were performed. Strength of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation system. RESULTS Data were extracted from a total of 48 identified studies. Achieving sustained virological response (SVR) was associated with reduced extrahepatic mortality (vs no SVR, OR 0.44 (95% CI 0.28 to 0.67)). SVR was associated with higher complete remissions in patients with cryoglobulinemia vasculitis (OR 20.76 (6.73 to 64.05)) and a higher objective response in those with malignant B-cell lymphoproliferative diseases (OR 6.49 (2.02 to 20.85)). Achieving SVR was also associated with reduced insulin resistance at follow-up (OR 0.42 (0.33 to 0.53)) and a significant protective effect on the incidence of diabetes (OR 0.34 (0.21 to 0.56)). Lack of randomised data comparing SVR versus non-SVR patients for the relevant extrahepatic indications attenuated these analyses. CONCLUSION Antiviral therapy can reduce extrahepatic manifestations related to HCV when SVR is achieved. Higher quality data, and reporting over longer follow-up periods, will be required to thoroughly explore comprehensive HCV treatment strategies.
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Affiliation(s)
- Patrice Cacoub
- Sorbonne Universités, UPMC Univ Paris, Paris, France.,Inflammation-Immunopathology-Biotherapy Department, DHU i2B, Paris, France.,INSERM, UMRS 959, Paris, France.,Department of Internal Medicine and Clinical Immunology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Anne Claire Desbois
- Sorbonne Universités, UPMC Univ Paris, Paris, France.,Inflammation-Immunopathology-Biotherapy Department, DHU i2B, Paris, France.,INSERM, UMRS 959, Paris, France.,Department of Internal Medicine and Clinical Immunology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Cloe Comarmond
- Sorbonne Universités, UPMC Univ Paris, Paris, France.,Inflammation-Immunopathology-Biotherapy Department, DHU i2B, Paris, France.,INSERM, UMRS 959, Paris, France.,Department of Internal Medicine and Clinical Immunology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - David Saadoun
- Sorbonne Universités, UPMC Univ Paris, Paris, France.,Inflammation-Immunopathology-Biotherapy Department, DHU i2B, Paris, France.,INSERM, UMRS 959, Paris, France.,Department of Internal Medicine and Clinical Immunology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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14
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Fattahi S, Nikbakhsh N, Taheri H, Ghadami E, Kosari-Monfared M, Amirbozorgi G, Asouri M, Pilehchian-Langroudi M, Ranaee M, Samadani AA, Paryan M, Akhavan-Niaki H. Prevalence of multiple infections and the risk of gastric adenocarcinoma development at earlier age. Diagn Microbiol Infect Dis 2018; 92:62-68. [DOI: 10.1016/j.diagmicrobio.2018.04.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/24/2018] [Accepted: 04/30/2018] [Indexed: 02/07/2023]
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