546. Direct-acting antivirals induce lymphoproliferative disease response in HCV-infected patients: A prospective case series
Session: Poster Abstract Session: Hepatitis B and C in Varied Settings
Thursday, October 5, 2017
Room: Poster Hall CD
Posters
  • Direct-acting antivirals induce lymphoproliferative disease response in HCV-infected patients-IDweek-Final (2) (1).pdf (537.5 kB)
  • Background:

    Hepatitis C virus (HCV) infection is associated with the development of B-cell Non-Hodgkin lymphoma (NHL). Several studies report regression of indolent NHL in HCV-infected patients treated with interferon (IFN)-containing therapy without chemotherapy. We are describing, herein, the oncologic response of patients with such cancers treated with only direct antiviral agents (DAAs).

    Methods:

    Patients with HCV-associated NHL seen at MD Anderson Cancer Center (6/2014 to 6/2017) and treated with DAAs were followed and those with indolent NHL treated with DAAs were further analyzed. DAA regimens were administered according to guidelines for HCV-infected patients without cancer. Efficacy was calculated on the basis of achieving sustained virologic response 12 weeks (SVR12) after end of treatment (EOT). NHL status was evaluated at the time of DAAs initiation and response was prospectively analyzed at 6 months after EOT using WHO criteria.

    Results:

    Six patients received DAAs alone as first line management of their NHL. Most patients 5/6 (83%) did respond to such treatment avoiding or delaying the use of chemotherapy (Table).

    Conclusion:

    As described with IFN-containing therapy, the oncologic outcome of HCV-infected patients with indolent NHL could also improve by using only DAAs.

    Table. Characteristics of six patients with indolent NHL treated with DAAs.

    Number of patients (%)

    N = 6

    Median age (IQR), years

    60 (55- 65)

    Gender, male

    4 (67)

    NHL subtype

    Marginal zone lymphoma*

    6 (100)

    HCV genotype

    1

    3 (50)

    2

    3 (50)

    rs12979860 genotype**

    CC

    2 (33)

    CT

    3 (50)

    TT

    1 (17)

    Cirrhosis

    0

    History of HCV treatment

    0

    DAA therapy

    Sofosbuvir + ribavirin

    2 (33)

    Sofosbuvir + simeprevir

    1 (17)

    Sofosbuvir + daclatasvir

    2 (33)

    Sofosbuvir + ledipasvir

    1 (17)

    DAA treatment duration of 12 weeks

    6 (100)

    NHL response after SVR

    Complete response

    2 (33)

    Partial response

    1 (17)

    Stable disease

    2 (33)

    Persistent disease

    1 (17)

    Chemotherapy needed after SVR

    3 (50)

    Abbreviations: IQR, interquartile range; NHL, Non-Hodgkin lymphoma; HCV, hepatitis C virus; DAA, direct acting agents; SVR, sustained virologic response.

    *Nodal (n = 1), Extranodal (n = 2) splenic (n = 1), and mucosa-associated lymphoid tissue lymphomas (n = 2)

    **Formerly known as interleukin 28b genotype.

    Jeff Hosry, M.D., Infectious Diseases, The University of Texas Health Science at Houston, Houston, TX, Minas Economides, M.D., University of Texas Health Science, Houston, TX, Felipe Samaniego, M.D., Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX and Harrys Torres, M.D., Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX

    Disclosures:

    J. Hosry, None

    M. Economides, None

    F. Samaniego, None

    H. Torres, Gilead Sciences: Consultant and Grant Investigator , Consulting fee , Grant recipient and Research support
    Merck & Co: Consultant and Grant Investigator , Consulting fee and Grant recipient
    Janssen Pharmaceuticals, Inc: Consultant , Consulting fee
    Dynavax Technologies: Consultant , Consulting fee

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