| Objective:The clinical features,liver damage and prognosis of patients with Hepatitis C virus(HCV))positive diffuse large B-cell lymphoma(DLBCL)were analyzed retrospectively,so as to deepen the understanding of this disease,guide the diagnosis and treatment,and improve the prognosis.Methods:A total of 399 patients with DLBCL diagnosed in our center from January 1,2009 to December 31,2019 were collected,including 20 patients with HCV positive DLBCL,accounting for 5%.According to the inclusion criteria of the study,66 DLBCL patients were selected,including 19 HCV positive patients with a median age of 63 years(range,47-76 years)with an average age of 61.5 years,and 47HCV-negative patients with a median age of 60 years(range,14-75 years)with an average age of 57.2 years.Retrospective analysis of the clinical data and survival status of the patients.Using overal survival(OS)to evaluate survival status,OS is defined as the time from the date of diagnosis until death from any cause or last follow-up(January 01,2021),measured in "months".The data were analyzed by SPSS26.0 statistical software,the utilization rate of counting data was expressed,and chi-square test was used to compare the counting data.When the theoretical frequency was less than 5,the exact probability method of Fisher was used,and the test level was 0.05,which was statistically significant.Survival analysis was performed by Kapla-Meier survival curve and Log-rangk test.Results:1.There were 19 cases of HCV positive group,the median age was63 years old(range,47-76 years old),the average age was 61.5 years old.There were 47 cases in HCV negative group,with a median age of 60 years old(range from 14 to 75 years old),with an average age of 57.2years old.2.Ann Arbor stage Ⅲ/Ⅳ accounted for 73.7%(14/19)in HCV positive group and 44.7%(21/47)in HCV negative group,and the difference was statistically significant(P=0.033);The increase of β2microglobulin accounted for 63.2%(12/19)in HCV positive group and25.5%(12/47)in HCV negative group,and the difference was statistically significant(P=0.004).The decrease of albumin in HCV positive group accounted for 68.4%(13/19),and 25.5%(12/47)in HCV negative group,and the difference was statistically significant(P=0.001).Other clinical features,such as age,sex,B symptoms,bone marrow involvement,increased Lactatedehydrogenase(LDH),spleen involvement,ECOG score,International Prognostic Index(IPI)score and cell origin,had no significant difference.3.The incidence of liver damage was 31.6%(6/19)in the HCV positive group and 17%(8/47)in the HCV negative group,and the difference was not statistically significant(P=0.328).4.The incidence of liver damage in patients treated with chemotherapy combined with antiviral drugs was lower than that in patients treated with sequential antiviral therapy after chemotherapy,but there was no significant difference between the two groups(20% vs35.7%).5.The Objective Response Rate(ORR)of the HCV positive group was 68.4%(13/19),and the ORR of the HCV negative group was 72.3%(34/47),and the difference was not statistically significant(P=0.750).6.The 3-year survival rate was 57.9% in the HCV positive group and 60% in the HCV negative group,and the difference was not statistically significant(P=0.450).Conclusion:1.The median age and average age of onset in HCV positive DLBCL patients were higher than those in HCV negative DLBCL patients.2.HCV positive DLBCL patients with late clinical stage,prone to β2microglobulin increased,albumin decreased.3.There was no significant difference in the incidence of liver damage between HCV positive DLBCL patients and HCV negative DLBCL patients.4.There was no significant difference in objective response rates and3-year overall survival after treatment between HCV-positive and HCV-negative DLBCL patients.5.The application of direct antiviral drugs in combination with chemotherapy is safe and effective,and the effect of preventing liver damage is better than that of sequential antiviral therapy after chemotherapy. |
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