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THERAPY WITH DIRECT ANTIVIRAL AGENTS IN PATIENTS WITH HCV-RELATED LYMPHOPROLIFERATIVE DISORDERS AND MIXED CRYOGLOBULINEMIA
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" Conclusions: HCV eradication with DAAs is safe in patients with MCs and/or B-NHL, and it is associated with clinical improvement and haematological response or stability."
Reported by Jules Levin
EASL 2017 April 19-23 Amsterdam Netherlands
Ludovica Venezia MD, Giulia Troshina, Alessandra Tucci MD, Paola Ponzo MD, Marco Sacco MD, Antonina Smedile MD, Mario Rizzetto MD, Giorgio Maria Saracco MD, Alessia Ciancio MD
University of Turin - Department of Medical Science
S.C. Gastroenterology U - A.O.U. Città della Salute e della Scienza, Turin, Italy
Ferri C et al, Arthritis research & therapy, 2012;14(3):215
- https://arthritis-research.biomedcentral.com/articles/10.1186/ar3865
Vannata B, Arcaini L et al. There Adv in Hematology, 2016; 7(2):94-107
- http://journals.sagepub.com/doi/full/10.1177/2040620715623924
Program abstract
Background and Aims: Treating patients with hepatitis C virus (HCV) and extrahepatic manifestations (symptomatic mixed cryoglobulinemia (MC) and/or B-cell Non Hodgkin Lymphomas (B-NHL)) is a priority.Direct acting antivirals (DAAs) have significantly changed the history of hepatitis C virus (HCV) infection, inducing high rates of sustained virologic response (SVR). Treating patients with HCV and extrahepatic manifestations (symptomatic mixed cryoglobulinemia (MC) and/or B-cell Non Hodgkin Lymphomas (B-NHL)) is a priority.The aim is to evaluate the outcome of patients with MC and/or B-NHL and HCV after eradication with DAAs.
Methods: We analyzed virological and hematological end points in 67 patients (25 Male / 42 Female, mean age 63.7 (± 12.1)) with MC and/or B-NHL treated with DAAs. HCV genotype was 1a in 40 patients, 1b in 5, 2 in 13, 3 in 7, 4 in 1, 5 in 1. 34 patients were naive, 21 non responder and 12 relapser to INF-based therapy. 31 patients were cirrhotics (46.3%). Symptomatic MC was present in 32 patients, and in 9 of them was associated with a B-NHL. 44 patients had B-NHL: diffuse large B-cell (10), marginal zone (9), follicular (7), MGUS (6), mantellar (1), others were indolent B-cell NHL not otherwise specified.We analyzed virological and hematological end points in 67 patients (25 Male / 42 Female, mean age 63.7 (± 12.1)) with MC and/or B-NHL treated with DAAs. HCV genotype was 1a in 40 patients, 1b in 5, 2 in 13, 3 in 7, 4 in 1, 5 in 1. 34 patients were naive, 21 non responder and 12 relapser to INF-based therapy. 31 patients were cirrhotics (46.3%). Symptomatic MC was present in 32 patients, and in 9 was associated with a B-NHL. 44 patients had B-NHL.
Results: SVR12 has been obtained in 67 patients (100%). At follow-up all patients with MC had an improvement in clinical symptoms, in 27 patients (84%) cryoglobulines were undetectable, while 5 had a decrease in cryoctrit. Considering patients with B-NHL, one patient died for disease progression, while the others showed partial haematological regression or disease stability.SVR12 was obtained in 67 patients (100%). At follow-up all patients with MC had an improvement in clinical symptoms, in 27 patients (84%) cryoglobulines were undetectable, while 5 had a decrease in cryoctrit. Considering patients with B-NHL, one patient died for disease progression, while the others showed partial haematological regression or disease stability.
Conclusions: HCV eradication with DAAs is safe in patients with MCs and/or B-NHL, and it is associated with clinical improvement and haematological response or stability.
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