Contributions
Abstract: EP520
Type: E-Poster Presentation
Session title: Aggressive Non-Hodgkin lymphoma - Clinical
Background
Increasing evidence suggested that viral infection contributes to lymphomagenesis. Plenty of studies indicated that hepatitis C virus (HCV) infection is associated with diffuse large B-cell lymphoma (DLBCL). However, no clear consensus has been reached about the impact of HCV infection on DLBCL patients’ clinical features and outcomes.
Aims
We therefore performed a systematic review and meta-analysis to explore the clinical characteristics and prognosis in DLBCL patients with HCV infection.
Methods
PubMed, Embase and Cochrane Library database were searched for retrospective study up to Dec 31, 2020. The primary outcome was survival outcomes, including overall survival (OS) and progression-free survival (PFS). The secondary outcomes measured rate of complete remission (CR) and partial remission (PR), the incidence of hepatic dysfunction during chemotherapy and clinical characteristics. Newcastle-Ottawa Quality Assessment Scale (NOS) was adopted to assess the methodological quality of included studies. Hazard ratio (HR) or odds ratio (OR) corresponding to 95% confidence interval (CI) were calculated to estimate outcomes. Publication biases were assessed by funnel plots. Statistical analyses were performed by the software RevMan 5.4.
Results
There were in total 11 studies included in the current meta-analysis, comprising of 532 HCV infected DLBCL patients and 7907 HCV non-infected DLBCL patients. All the included studies had reliable quality as indicated by NOS scores ≥ 6 points. Our data demonstrated that DLBCL patients with HCV infection showed significantly shorter OS (HR 2.29; 95% CI 1.85~2.84, P<0.00001) and PFS (HR 1.52; 95% CI 1.27~1.82, P<0.00001), lower rate of CR+PR (OR 0.55; 95% CI 0.42~0.72, P<0.00001) and higher incidence of hepatic dysfunction during chemotherapy (OR 5.89; 95% CI 2.31~15.01, P=0.0002) compared with DLBCL patients without HCV infection. Furthermore, HCV infected DLBCL patients were characterized by higher International Prognostic Index scores (OR 1.36; 95% CI 1.10~1.68, P=0.005), higher level of LDH (OR 1.45; 95% CI 1.16~1.80, P=0.0009) and more frequent involvement of spleen (OR 2.75; 95% CI 1.92~3.95, P<0.00001) and liver (OR 1.87; 95% CI 1.22~2.85, P=0.004) at diagnosis in comparison to HCV non-infected DLBCL patients. However, there was no significant difference in age of disease onset, disease stage, present of B symptoms and incidence of involvement of bone marrow between two groups of patients. Funnel plots indicated no evidence for publication bias.
Conclusion
The current study provided the compelling evidence about an inferior prognosis and distinct clinical characteristics in HCV infected DLBCL patients. DLBCL patients with HCV infection were prone to undergoing hepatic dysfunction during chemotherapy.
Keyword(s): Diffuse large B cell lymphoma, Hepatitis C virus, Meta-analysis, Prognosis
Abstract: EP520
Type: E-Poster Presentation
Session title: Aggressive Non-Hodgkin lymphoma - Clinical
Background
Increasing evidence suggested that viral infection contributes to lymphomagenesis. Plenty of studies indicated that hepatitis C virus (HCV) infection is associated with diffuse large B-cell lymphoma (DLBCL). However, no clear consensus has been reached about the impact of HCV infection on DLBCL patients’ clinical features and outcomes.
Aims
We therefore performed a systematic review and meta-analysis to explore the clinical characteristics and prognosis in DLBCL patients with HCV infection.
Methods
PubMed, Embase and Cochrane Library database were searched for retrospective study up to Dec 31, 2020. The primary outcome was survival outcomes, including overall survival (OS) and progression-free survival (PFS). The secondary outcomes measured rate of complete remission (CR) and partial remission (PR), the incidence of hepatic dysfunction during chemotherapy and clinical characteristics. Newcastle-Ottawa Quality Assessment Scale (NOS) was adopted to assess the methodological quality of included studies. Hazard ratio (HR) or odds ratio (OR) corresponding to 95% confidence interval (CI) were calculated to estimate outcomes. Publication biases were assessed by funnel plots. Statistical analyses were performed by the software RevMan 5.4.
Results
There were in total 11 studies included in the current meta-analysis, comprising of 532 HCV infected DLBCL patients and 7907 HCV non-infected DLBCL patients. All the included studies had reliable quality as indicated by NOS scores ≥ 6 points. Our data demonstrated that DLBCL patients with HCV infection showed significantly shorter OS (HR 2.29; 95% CI 1.85~2.84, P<0.00001) and PFS (HR 1.52; 95% CI 1.27~1.82, P<0.00001), lower rate of CR+PR (OR 0.55; 95% CI 0.42~0.72, P<0.00001) and higher incidence of hepatic dysfunction during chemotherapy (OR 5.89; 95% CI 2.31~15.01, P=0.0002) compared with DLBCL patients without HCV infection. Furthermore, HCV infected DLBCL patients were characterized by higher International Prognostic Index scores (OR 1.36; 95% CI 1.10~1.68, P=0.005), higher level of LDH (OR 1.45; 95% CI 1.16~1.80, P=0.0009) and more frequent involvement of spleen (OR 2.75; 95% CI 1.92~3.95, P<0.00001) and liver (OR 1.87; 95% CI 1.22~2.85, P=0.004) at diagnosis in comparison to HCV non-infected DLBCL patients. However, there was no significant difference in age of disease onset, disease stage, present of B symptoms and incidence of involvement of bone marrow between two groups of patients. Funnel plots indicated no evidence for publication bias.
Conclusion
The current study provided the compelling evidence about an inferior prognosis and distinct clinical characteristics in HCV infected DLBCL patients. DLBCL patients with HCV infection were prone to undergoing hepatic dysfunction during chemotherapy.
Keyword(s): Diffuse large B cell lymphoma, Hepatitis C virus, Meta-analysis, Prognosis