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Tsutsumi Y, Ito S, Shiratori S, Teshima T. Hepatitis C Virus (HCV)-Ribonucleic Acid (RNA) As a Biomarker for Lymphoid Malignancy with HCV Infection. Cancers (Basel) 2023; 15:2852. [PMID: 37345190 DOI: 10.3390/cancers15102852] [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: 04/25/2023] [Revised: 05/15/2023] [Accepted: 05/15/2023] [Indexed: 06/23/2023] Open
Abstract
The hepatitis C virus (HCV) is potentially associated with liver cancer, and advances in various drugs have led to progress in the treatment of hepatitis C and attempts to prevent its transition to liver cancer. Furthermore, reactivation of HCV has been observed in the treatment of lymphoma, during which the immortalization and proliferation of lymphocytes occur, which leads to the possibility of further stimulating cytokines and the like and possibly to the development of lymphoid malignancy. There are also cases in which the disappearance of lymphoid malignancy has been observed by treating HCV and suppressing HCV-Ribonucleic acid (RNA), as well as cases of recurrence with an increase in HCV-RNA. While HCV-associated lymphoma has a poor prognosis, improving the prognosis with Direct Acting Antivirals (DAA) has recently been reported. The reduction and eradication of HCV-RNA by means of DAA is thus important for the treatment of lymphoid malignancy associated with HCV infection, and HCV-RNA can presumably play a role as a biomarker. This review provides an overview of what is currently known about HCV-associated lymphoma, its epidemiology, the mechanisms underlying the progression to lymphoma, its treatment, the potential and limits of HCV-RNA as a therapeutic biomarker, and biomarkers that are expected now that DAA therapy has been developed.
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Affiliation(s)
- Yutaka Tsutsumi
- Department of Hematology, Hakodate Municipal Hospital, Hakodate, 1-10-1, Minato-cho, Hakodate 041-8680, Japan
| | - Shinichi Ito
- Department of Hematology, Hakodate Municipal Hospital, Hakodate, 1-10-1, Minato-cho, Hakodate 041-8680, Japan
| | - Souichi Shiratori
- Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
| | - Takanori Teshima
- Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
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Elbedewy TA, Elashtokhy HEA, Abd-Elsalam S, Suliman MA. Hepatitis C Virus Infection and Treatment as Independent Prognostic Factors in Diffuse Large B-Cell Lymphoma Egyptian Patients. Curr Cancer Drug Targets 2021; 20:638-645. [PMID: 32392114 DOI: 10.2174/1568009620666200511084731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 02/28/2020] [Accepted: 03/17/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Egypt is one of the highest hepatitis C virus (HCV) endemic areas. Chronic HCV infection has extra-hepatic manifestations, including non-Hodgkin lymphoma (NHL). Diffuse large B-cell lymphoma (DLBCL) is commonly associated with HCV infection. The prognostic value of HCV infection and HCV treatment in patients with DLBCL remains unclear until now. OBJECTIVE The aim of our study is to evaluate the impact of HCV infection and HCV treatment as independent prognostic factors on the event-free survival (EFS) and overall survival (OS) in Egyptian patients with HCV associated DLBCL. METHODS This study included 353 patients with DLBCL, collected retrospectively. While 34 patients with HCV who received HCV antiviral therapy were collected prospectively. Patient's characteristics were collected from the patient records at the time of diagnosis. The status of the patients about HCV infection and HCV treatment were also recorded. Disease progression, relapse, retreatment or deaths were also verified through medical records. EFS and OS were calculated. RESULTS EFS and OS significantly decrease in HCV infected and HCV non-treated patients when compared with HCV non-infected and HCV treated patients, respectively. HCV infection but not HCV treatment was independently associated with EFS and OS using univariate and multivariate analysis. CONCLUSION Hepatitis C virus infection is an independent prognostic factor for EFS and OS in diffuse large B-cell lymphoma. HCV treatment is associated with higher EFS and OS but can not be considered as an independent prognostic factor.
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Affiliation(s)
- Tamer A Elbedewy
- Internal Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | | | - Marwa A Suliman
- Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Suez Canal University, Al Ismailia, Egypt
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Abstract
Infectious agents, such as HCV, account for ∼15% of human cancers. HCV infects not only hepatocytes but also extrahepatic cells. Chronic HCV infection can induce chronic inflammation with qualitative and quantitative alterations of the immune repertoire and tissue microenvironment, which could induce various neoplasias. Epidemiological studies and meta-analyses suggest an increased rate of extrahepatic cancers in patients with chronic HCV infection along with a higher risk of intrahepatic cholangiocarcinoma, pancreatic cancer and non-Hodgkin lymphoma (NHL), highlighting the need to screen for HCV infection in patients with these cancers. Development of B cell NHL has been associated with HCV infection, with a relative risk of ∼1.5. Direct transformation related to the presence of the virus and chronic antigenic stimulation are the two major non-exclusive mechanisms involved in HCV-related lymphomagenesis. HCV infection alters survival of patients with lymphoma, and sustained virologic response (SVR) substantially improves prognosis. Antiviral treatments might induce remission of indolent lymphoma when SVR is achieved even without chemotherapy, emphasizing the role of HCV in lymphomagenesis in this context. However, studies are needed to provide prospective evidence of a causal relationship between chronic HCV infection and other extrahepatic cancers and to determine whether the risk of extrahepatic cancers is reduced with SVR. In this Review, we report on recent studies analysing the risk of extrahepatic cancers associated with chronic HCV infection. Although there is no doubt regarding the direct and indirect causality between HCV and NHL, an increased risk of other cancers is less clear, with the exception of cholangiocarcinoma.
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Canioni D, Michot JM, Rabiega P, Molina TJ, Charlotte F, Lazure T, Davi F, Settegrana C, Berger F, Alric L, Cacoub P, Terrier B, Suarez F, Sibon D, Dupuis J, Feray C, Tilly H, Pol S, Deau Fischer B, Roulland S, Thieblemont C, Leblond V, Carrat F, Hermine O, Besson C. In Situ Hepatitis C NS3 Protein Detection Is Associated with High Grade Features in Hepatitis C-Associated B-Cell Non-Hodgkin Lymphomas. PLoS One 2016; 11:e0156384. [PMID: 27257992 PMCID: PMC4892517 DOI: 10.1371/journal.pone.0156384] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/15/2016] [Indexed: 12/15/2022] Open
Abstract
Hepatitis C Virus (HCV) infection is associated with the B-cell non-Hodgkin lymphomas (NHL), preferentially marginal zone lymphomas (MZL) and diffuse large B-cell lymphomas (DLBCL). While chronic antigenic stimulation is a main determinant of lymphomagenesis in marginal zone lymphomas (MZL), a putative role of HCV infection of B-cells is supported by in vitro studies. We performed a pathological study within the "ANRS HC-13 LymphoC" observational study focusing on in situ expression of the oncogenic HCV non structural 3 (NS3) protein. Lympho-C study enrolled 116 HCV-positive patients with B-NHL of which 86 histological samples were collected for centralized review. Main histological subtypes were DLBCL (36%) and MZL (34%). Almost half of DLBCL (12/26) were transformed from underlying small B-cell lymphomas. NS3 immunostaining was found positive in 17 of 37 tested samples (46%). There was a striking association between NS3 detection and presence of high grade lymphoma features: 12 out of 14 DLBCL were NS3+ compared to only 4 out of 14 MZL (p = 0.006). Moreover, 2 among the 4 NS3+ MZL were enriched in large cells. Remarkably, this study supports a new mechanism of transformation with a direct oncogenic role of HCV proteins in the occurrence of high-grade B lymphomas.
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Affiliation(s)
- Danielle Canioni
- Department of Pathology, Paris Descartes University, AP-HP, Sorbonne Paris Cité, Hôpital Necker, Paris, France
- * E-mail: (CB); (DC); (OH)
| | - Jean-Marie Michot
- Department of Hematology and Drug Development, Gustave Roussy Institute, Villejuif, F-94805, France
| | - Pascaline Rabiega
- Institut Pierre Louis d’Epidémiologie et de Santé Publique INSERM UMR S1136, Paris 6 Pierre et Marie Curie University, Paris, France
| | - Thierry J. Molina
- Department of Pathology, Paris Descartes University, AP-HP, Sorbonne Paris Cité, Hôpital Necker, Paris, France
| | - Frédéric Charlotte
- Department of Pathology, HôpitalPitié-Salpétrière, Paris 6 Pierre et Marie Curie University, Paris, France
| | - Thierry Lazure
- Department of Pathology, Paris 11 Sud University, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Frédéric Davi
- Department of Biological Hematology, Paris 6 Pierre et Marie Curie University, AP-HP, Hôpital Pitié-Salpétrière, Paris, France
| | - Catherine Settegrana
- Department of Biological Hematology, Paris 6 Pierre et Marie Curie University, AP-HP, Hôpital Pitié-Salpétrière, Paris, France
| | - Françoise Berger
- Department of Pathology, Hopital Lyon Sud, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Lyon, France
| | - Laurent Alric
- Department of Internal Medicine and Digestive Diseases, Toulouse 3 University, UMR 152 IRD, Hôpital Purpan, Toulouse, France
| | - Patrice Cacoub
- Department of Internal Medicine, APHP, Hôpital Pitié-Salpétrière, Paris 6 Pierre et Marie Curie University, UMR 7211, INSERM, UMR S 959, CNRS, Paris, France
| | - Benjamin Terrier
- Department of Internal Medicine, APHP, Hôpital Pitié-Salpétrière, Paris 6 Pierre et Marie Curie University, UMR 7211, INSERM, UMR S 959, CNRS, Paris, France
| | - Felipe Suarez
- Department of Adult Hematology, Paris 5 Descartes University, AP-HP, Hôpital Necker, Paris, France
- Imagine Institute, University Sorbonne Paris Cité, INSERM U 1163, CNRS ERL 8254, Paris, France
| | - David Sibon
- Department of Adult Hematology, Paris 5 Descartes University, AP-HP, Hôpital Necker, Paris, France
- Imagine Institute, University Sorbonne Paris Cité, INSERM U 1163, CNRS ERL 8254, Paris, France
| | - Jehan Dupuis
- Department of Lymphoid Malignancies and Clinical Hematology, Paris 12 Est Créteil University, AP-HP, Hôpital Henri-Mondor, Créteil, France
| | - Cyrille Feray
- Department of Hepatology, Nantes University, Hôpital de Nantes, Nantes, France
| | - Hervé Tilly
- Department of Hematology, Rouen University, Centre Henri Becquerel, Rouen, France
| | - Stanislas Pol
- Department of Hepatology, Paris 5 Descartes University, INSERM U-1016, AP-HP, Hôpital Cochin, Paris, France
| | - Bénédicte Deau Fischer
- Department of Hematology, Paris Descartes University, AP-HP, Hôpital Cochin, Paris, France
| | - Sandrine Roulland
- Centre d'Immunologie de Marseille Luminy, Aix-Marseille Université INSERM U1104 CNRS UMR7280, Marseille, France
| | - Catherine Thieblemont
- Department of Hemato-oncology, University Paris Sorbonne P7, INSERM U728, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Véronique Leblond
- Department of Clinical Hematology, Paris 6 Pierre et Marie Curie, Paris, France
| | - Fabrice Carrat
- Institut Pierre Louis d’Epidémiologie et de Santé Publique INSERM UMR S1136, Paris 6 Pierre et Marie Curie University, Paris, France
| | - Olivier Hermine
- Department of Adult Hematology, Paris 5 Descartes University, AP-HP, Hôpital Necker, Paris, France
- Imagine Institute, University Sorbonne Paris Cité, INSERM U 1163, CNRS ERL 8254, Paris, France
- * E-mail: (CB); (DC); (OH)
| | - Caroline Besson
- Department of Internal Medicine & Clinical Immunology Biological Immunology and Hematology, Paris 11 Sud University, AP-HP, Hôpital Bicêtre, INSERM U 1184, Le Kremlin-Bicêtre, France
- * E-mail: (CB); (DC); (OH)
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