1079P - The outcome of lymphoma patients with hepatitis c virus undergoing anticancer therapy plus rituximab

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Anti-Cancer Agents & Biologic Therapy
Lymphomas
Cancer in Special Situations
Presenter Lobna Ezz Elarab
Authors L. Ezz Elarab1, M.M.A.M. Wahab2, M. Swellam3, M. Ezz Alarab4
  • 1Clinical Oncology, Ain Shams University, Cairo/EG
  • 2Clinical Oncology Department, Ain Shams University, Cairo/EG
  • 3Biochemistry Dept., National research Center, Cairo/EG
  • 4Hepatology And Tropical Medicine, National Hepatology and Tropical Medical Research Institute, Cairo/EG

Abstract

Rationale: Hepatitis C Virus (HCV) is an endemic disease in Egypt due to parenteral treatment of Egyptian patients with bilharziasis. Recently, it was concluded that the introduction of rituximab in combination with chemotherapy has been associated with hepatitis B reactivation but with HCV infection it is still a matter od debate. The objectives of the current study were to evaluate the safety profile and efficacy of rituximab plus CHOP in patients with lymphoma plus virus C.

Patients and methods

Between January 2008 and June 2009, forty three chemo-naïve patients with large B cell lymphoma were enrolled. All cases were strongly expressed CD 20 .Baseline HCV serology results were requested “detection of antigens by polymerase chain reaction (PCR) or antibodies by Enzyme Linked Immuno- sorbent Assay (ELISA)”. All patients were observed for hepatic toxicity and HCV reactivation.

Results

All patients were assessable for response and safety. The included patients characterized by median age was 47, nodal presentation in 28 cases, LDH level was elevated in 60%, no patients had history of cirrhosis, 18 had been treated for HCV & Transaminase (AST & ALT) levels at inclusion were normal in 29 patients (67%) and grade I in 14 (33 %), PCR was negative in 32 patients & low viremia in the 25 % of cases. 25 patients had low risk lymphoma according to the International Prognostic Index (IPI) and the remainder had high & high- intermediate risk. The overall hepatic toxicity of R-CHOP was reported in 28 patients (65%) and from those 71% were GI and II (20 patients) (median no. of cycles = 4, Range 2-8). 4 patients developed HCV reactivation by PCR, 2 cases after cycle 6 and 2 within 6 months of therapy.

Outcome

Complete Remission for uncertain CR was 29/43 (67%). With the median follow up of 32 months, The 2 year overall survival was 70% (95%CI 59-81%) and disease free survival was 59% (95% CI 48-70%) with no recorded treatment related mortality. Dose reduction was required for toxicity in 25% of all patients.

Conclusion

Rituximab plus CHOP is an effective and marginally tolerable regimen in therapy of HCV +ve lymphoma patients. Role of prophylactic antiviral therapy has to be evaluated for those patients.

Disclosure

All authors have declared no conflicts of interest.