Novelty and Impact: This first study compares the survival of HCV-positive DLBCL treated with and without
rituximab which showed in toxicity and the outcome.
Background: The effect of hepatitis C virus (HCV) infection on prognosis and hepatic toxicity in patients with
diffuse large B-cell lymphoma (DLBCL) in the rituximab era is unclear. The treatment and the outcome of
patients with DLBCL and HCV infection are still a matter of debate.
Methods: We analyzed 137 DLBCL patients positive to HCV, treated with chemotherapy regimens include
cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) ± rituximab. Survival outcomes and
hepatic toxicity were compared in DLBCL patients positive to HCV infection according to CHOP ± rituximab.
Result: Our result showed that the group of patients treated with R-CHOP has significant high incidence of
hepatic toxicity grade (3–4) (28 vs. 18%, P value 0.001) and worse progression-free survival (55 vs. 80%,
P value 0.002) in comparison with the group treated with CHOP, and also there is significant difference
between both groups in overall survival. This first study compares the survival of HCV-positive DLBCL
treated with and without rituximab which showed significant differences.
Conclusion:We conclude that HCV-positive patients with DLBCL treated with rituximab plus CHOP have high
incidence in hepatic toxicity. Specific protocols evaluating antiviral therapy should be designed for these
patients