Direct-acting antivirals in relapsed or refractory hepatitis C virus-associated diffuse large B-cell lymphoma

Abstract

Recent studies have demonstrated feasibility and substantial benefit of direct-acting antivirals (DAAs) administration during or after first-line immune-chemotherapy (I-CT) in patients with hepatitis C virus (HCV)-positive diffuse large B-cell lymphomas (DLBCL). However, data on DAAs used during or after salvage treatments are still lacking. In this study we assessed clinical and virological outcome in 11 patients with relapsed (n = 7) or refractory (n = 4) HCV-positive DLBCL. DAAs were given either concurrently (n = 3) or subsequent (n = 8) to salvage I-CT. Most patients (10 of 11) received sofosbuvir-based regimens. All patients completed their planned courses of DAAs and achieved sustained virological response. DAAs were well tolerated, with no grade ≥2 adverse events. At a median follow-up of 3.6 years four patients died (4-year OS: 76%). In conclusion, we provide evidence that DAAs in HCV-positive relapsed/refractory DLBCL are extremely safe and effective, suggesting that they should be used if HCV eradication was not instituted before.

Keywords:

• Diffuse large B-cell lymphoma (DLBCL)
• salvage therapy
• hepatitis C virus (HCV)
• direct-acting antivirals (DAA)

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The Varese group was supported by grants of the Fondazione Regionale Ricerca Biomedica (FRRB), Milan, Italy (FRRB project no. 2015-0042, genomic profiling of rare hematologic malignancies, development of personalized medicine strategies, and their implementation into the Rete Ematologica Lombarda clinical network), by Fondazione Matarelli (Milano, Italy), Fondazione Rusconi (Varese, Italy) and AIL Varese ONLUS. The Pavia group was supported by grants of AIRC (under IG 2017- ID. 20767 project – P.I. Luca Arcaini) and of “Ricerca Corrente Fondazione IRCCS Policlinico San Matteo” (P.I. Luca Arcaini).