HCV clearance improves aggressive lymphoma outcomes for African Americans
ORLANDO — African Americans with lymphoma and hepatitis C virus should be treated for both disease states to improve response to lymphoma treatment, with most improved results seen in patients with aggressive lymphoma, according to a poster presenter at the ASH Annual Meeting and Exposition.
“Patients with hepatitis C-associated lymphoma and virologic clearance of hepatitis C responded significantly better to lymphoma treatment, which means that patients whose hepatitis C was treated successfully had significantly higher overall response rates and complete response rates to lymphoma chemotherapy that translated to higher overall survival in those patients,” Sanjal H. Desai, MD, of Medstar Health, told HemOnc Today.
In the study, Desai and colleagues looked at 40 patients with HCV and non-Hodgkin lymphoma, 21 of whom received treatment for their HCV and 19 who remained untreated. Of those 40 patients, 22 achieved viral clearance.
Researchers saw overall response rates in 21 (95%) of those who achieved viral clearance, compared with 11 (69%) of those who did not (RR = 2.4; P < .05). Complete response was seen in 16 (73%) of the viral clearance cohort vs. six (38%) of those who did not clear HCV (RR = 2.29; P < .05).
Desai showed that median OS was at 89 months for patients who did not clear their HCV, and the median OS was not reached in those that did clear HCV (RR = 0.4; P < .05).
“Median overall survival was not reached, and most of the patients with virologic clearance were alive at the end of follow up,” Desai said.
Of note, 100% of patients with aggressive NHL and viral clearance responded, compared with 70% of those with aggressive NHL without viral clearance (RR = 1.44). Similarly, 100% of those with aggressive NHL and viral clearance had a complete response while just 46% of those with aggressive NHL without viral clearance reported a complete response (RR = 2.17; P = .005). All of the patients with diffuse large B-cell lymphoma also showed complete response when they cleared the HCV compared with just 45% of those who did not clear HCV (RR = 2.2; P = .03).
“We saw that in aggressive lymphoma, patients who had successfully treated hepatitis C had significantly higher response rate – 100% overall response rates and complete response rates – as compared to patients who did not have their hepatitis C cleared,” Desai said. “We already know that hepatitis C is associated with non-Hodgkin lymphoma and the successful treatment in especially indolent lymphoma leads to regression of lymphoma, but we did not have such strong data for aggressive lymphoma. My study reiterates that hepatitis c treatment is necessary even if you’re treating aggressive lymphoma.”
Desai said in her practice, if a lymphoma patient is found to have hepatitis C, she refers to infectious disease and starts both treatments concomitantly as it has been shown to be safe in a previously conducted phase 2 clinical trial. – by Katrina Altersitz
Desai S, et al. Abstract 1614. Presented at: ASH Annual Meeting and Exposition; Dec. 7-10, 2019; Orlando, Florida.
Disclosure: Desai reports no relevant financial disclosures.