Hepatitis C virus infection is an independent prognostic factor in follicular lymphoma
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Joji Shimono1,9, Hiroaki Miyoshi1, Takeharu Kato2,7, Takeshi Sugio3, Kohta Miyawaki3, Tomohiko Kamimura4, Takuto Miyagishima5, Tetsuya Eto6, Yoshitaka Imaizumi7, Koji Kato3, Koji Nagafuji8, Koichi Akashi3, Masao Seto1, Takanori Teshima9 and Koichi Ohshima1
1Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
2Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
3Department of Medicine and Biosystemic Science, Kyushu University Faculty of Medicine, Fukuoka, Japan
4Department of Hematology, Hara Sanshin Hospital, Fukuoka, Japan
5Department of Hematology, Kushiro Rosai Hospital, Kushiro, Japan
6Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
7Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
8Department of Hematology, Kurume University, School of Medicine, Kurume, Japan
9Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
Hiroaki Miyoshi, email: [email protected]
Keywords: follicular lymphoma; hepatitis C virus; poor prognosis; NS3; overall survival
Received: July 23, 2017 Accepted: November 13, 2017 Published: December 11, 2017
Hepatitis C virus (HCV) is a single-stranded RNA virus that not only affects hepatocytes, by B cells as well. It is thought that HCV is involved in the onset of B-cell lymphoma. The clinicopathological characteristics of HCV-positive diffuse large B-cell lymphoma (DLBCL) and HCV-positive splenic marginal zone lymphoma (SMZL) are known, but there has been no report on HCV-positive follicular lymphoma (FL). In this study, the clinicopathological characteristics of HCV-positive FL were examined in 263 patients with FL who were classified into a HCV-positive group with HCV antibody and negative groups without one. The number of patients with HCV-positive FL and HCV-negative FL was 10 (3.8%) and 253 (96.2%), respectively. The patients with HCV-positive FL commonly had more than one region of lymphadenopathy, Ann Arbor stage III/IV, hemoglobin <120 g/l, elevated lactate dehydrogenase level, and high-risk categorization of Follicular Lymphoma International Prognostic Index (FLIPI) than in patients with HCV-negative FL. Overall survival and progression-free survival were poorer in patients with HCV-positive FL than in those with HCV-negative FL (p < 0.0001 and 0.006, respectively). Also, multivariate analysis revealed that positive HCV antibody was a poor prognostic factor of OS. In conclusion, HCV-positive FL has unique clinical features and may have a great impact on the overall survival of affected patients.
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