Direct-acting antivirals in relapsed or refractory hepatitis C virus-associated diffuse large B-cell lymphoma
Michele Merli, Irene Defrancesco, Carlo Visco, Caroline Besson, Alice Di Rocco, Annalisa Arcari, Antonello Sica, Emanuele Cencini, Maria Chiara Tisi, Marco Frigeni, Paolo Grossi, Benedetta Bianchi, Barbara Mora, Lorenza Bertù, Raffaele Bruno, Francesco Passamonti, Luca Arcaini
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.