AbstractBackground.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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Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com
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Παρασκευή 14 Δεκεμβρίου 2018
Direct‐Acting Antivirals in Hepatitis C Virus‐Associated Diffuse Large B‐cell Lymphomas
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- Experiences of Dermatologic Surgeons With the Suns...
- Incidence, Risk Factors, Progression, and Treatmen...
- Discrepancy Between Online Images of Mohs Surgery ...
- The “Sketch, Etch, and Sketch” Approach to Improve...
- A Survey of Mohs Tissue Tracking Practices
- Clinical Evaluations of a Novel Thread Lifting Reg...
- Benefit of Mohs Micrographic Surgery Over Wide Loc...
- Repair of a Large Glabellar/Nasal Defect
- Cosmetics, Vol. 5, Pages 71: Preparation and Chara...
- Central serous retinopathy as presentation of an a...
- Bidirectional ventricular tachycardia due to hypok...
- MRI of radial cutaneous nerve abscess in recurrent...
- Pericardial effusion as a complication of chronic ...
- Potassium chloride mixture may maintain hypokalaem...
- Catatonia due to alprazolam withdrawal
- Late onset of dropped head syndrome following mant...
- Metastatic adenocarcinoma of mandible: in search o...
- Haemostatic radiation therapy for a bleeding intra...
- Renal sarcoidosis: a rare case
- Single right coronary artery with congenital absen...
- Primary mural infective endocarditis with associat...
- Thyroid storm: a case of haemodynamic failure prom...
- Dexmedetomidine-assisted drug interviews: an obser...
- Anaphylaxis after treatment with recombinant facto...
- Exogenous steroid-induced hypoadrenalism in a pers...
- Perivascular tumour balls in primary vitreoretinal...
- Giant juvenile papillomatosis of the breast in a N...
- Unusual case of cellulitis due to primary cutaneou...
- Case of a missed airway stent migration
- Benign paroxysmal positional vertigo and osteoporosis
- The Na+/H+ Exchanger Nhe1 Modulates Network Excita...
- Cytoarchitectonic segregation of human posterior i...
- Brain Functional Organization Associated With Lang...
- A Breakdown of Imagined Visuomotor Transformations...
- Roles of Ventromedial Prefrontal Cortex and Anteri...
- The Cerebral Cortex is Bisectionally Segregated in...
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- Herpes zoster‐associated paresis of the left arm
- The Relationship of Exhaled Nitric Oxide with Ethn...
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- miR-487b mitigates allergic rhinitis through inhib...
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- Making the Case for Sesame: A Major U.S. Food Alle...
- Pediatric Spontaneous Pneumothorax: Our Experience...
- Angiopoietin-1, Angiopoietin-2, and Periostin Leve...
- Comparison of 3 Indices for Assessing the Severity...
- Looking Towards the Future
- Relationship Between Health Literacy in Parents an...
- Role of the Airway Microbiome in Respiratory Infec...
- Direct Observed Therapy of Inhaled Corticosteroids...
- Highlights from the U.S. Asthma Summit 2018
- Hyaluronic acid is superior to autologous fat for ...
- Combination free foot flaps for digit reconstructi...
- Intraoral anastomosis of a vascularized iliac-cres...
- Nuss procedure for patients with pectus excavatum ...
- Keystone island flaps for reconstruction following...
- Perforator navigation using color Doppler ultrasou...
- Use of Integra Flowable Wound Matrix for nasal dor...
- Wound management in acute medicine
- The Influence of Marital Status on Contemporary Pa...
- Re: The Use of Ultrasound guidance for foreign bod...
- Measuring Visual Attention to Faces with Cleft Def...
- The Polish version of the Boston Carpal Tunnel Que...
- Anatomic Location of a Sensory Nerve to the Latera...
- Application of Suction Retractor for Lymphaticoven...
- Augmented Reality Microsurgical Planning with a Sm...
- Lower Eyelid Tension Balance Reconstruction: A New...
- Comparable investigation of polyaniline behavior t...
- Clear cell acanthoma (CCA)-like lesions of the nip...
- High prevalence of clinical spondyloarthritis feat...
- In vitro characterization of hepatic toxicity of A...
- The impact of public transportation on carbon emis...
- Acquired partial lipoatrophy as graft-versus-host ...
- Sensitivity of physiological and biochemical endpo...
- Effectiveness of 2% Articaine as an anesthetic age...
- Composite scaffold obtained by electro-hydrodynami...
- Distinctive Neuroanatomical Substrates for Depress...
- The Essentials-Only Emergency Tracheotomy Pan: Kee...
- Severe Facial-Disfiguring Xeroderma Pigmentosum Wi...
- Is It Time to Rethink the Approach to Internal Nas...
- Association Between Conventional Bicycle Helmet Us...
- Tumor Size Affects Efficacy of Adjuvant Transarter...
- Patient‐Reported Toxicities During Chemotherapy Re...
- Phase II Randomized Trial of Sequential or Concurr...
- Patient‐Reported Outcomes with PD‐1/PD‐L1 Inhibito...
- Safety and Activity of Sorafenib in Addition to Vi...
- Direct‐Acting Antivirals in Hepatitis C Virus‐Asso...
- Stereotaktische Strahlentherapie übertrifft Sorafe...
- Environmental performance of ordinary and new gene...
- Individualized Follow-Up Strategy for Patients wit...
- Role of “revascularization surgery” in the managem...
- Oral Cancer With Wide Excision and Free Flap Recon...
- Safety of CDNF by Brain Infusion in Patients With ...
- A Phase I Safety, Pharmacodynamic and Pharmacokine...
- The Role of Bathing Additives in the Treatment of ...
- Nivolumab, Ipilimumab and Chemoradiation in Treati...
- hand-foot syndrome due to paclitaxel: A rare case ...
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