The Impact of Outcome and Hepatic Toxicity in HCV-Infected Patients with Diffuse Large B-Cell Lymphoma Treated with Rituximab Plus CHOP Therapy; A Retrospective Multicenter Japanese Analysis.
Notice bibliographique
Résumé
Abstract Abstract 2700 Poster Board II-676 Background: Hepatitis B virus reactivation after systemic chemotherapy including rituximab is a well-documented complication. However, no studies have investigated the influence of hepatitis C virus (HCV) infection for hepatic toxicity of diffuse large B-cell lymphoma (DLBCL) patients treated by rituximab containing chemotherapy. The prognostic value of HCV infection in DLBCL in the era of rituximab was also unclear. Herein we conducted a multicenter retrospective analysis to compare the outcome and hepatic toxicity of DLBCL patients with and without HCV infection treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP) as an initial therapy. Methods: We analyzed 548 patients: HCV-positive (n=126) or -negative (n=422) patients with CD20-positive DLBCL receiving RCHOP between January 2004 and March 2008. HCV-negative patients treated during same period with HCV-positive patients in each institute were enrolled. Hepatitis B surface antigen positive patients were excluded in this study. For survival analysis, event-free survival (EFS) and overall survival (OS) were compared according to HCV infection. The definition of severe hepatic toxicity was more than Grade 3 transaminases increase according to National Cancer Institute of Canada criteria. The change of serum HCV-RNA levels was examined in 33 HCV-positive patients. Results: Before the treatment, HCV-positive patients had higher age (P<0.001), more frequently elevated lactate dehydrogenase levels (P=0.004), spleen involvement (P=0.001) and higher international prognostic index (P=0.01) than HCV-negative patients. HCV infection was not a significant risk factor for EFS and a borderline risk factor for OS (3-year EFS, 66% vs. 74%, P=0.20; OS, 77% vs. 84%, P=0.07). Cox multivariate analysis showed that HCV was not a significant poor risk factor. Thirty-three out of 126 (26%) HCV-positive patients had severe hepatic toxicity, compared to 3% HCV-negative patients, and multivariate analysis revealed that HCV infection was significantly strong risk factor for hepatic toxicity (HR:14.72 (95%CI: 6.34–34.02)) (Table 1). The severe hepatic toxicity was not significantly associated with poor prognosis of HCV-positive patients, but chemotherapy was stopped in four of 33 patients due to severe hepatic toxicity and died of disease progression. The monitoring of HCV viral load demonstrated that HCV-RNA significantly increased during rituximab treatment (P=0.006) (median: 320 to 2000KIU/ml) and then decreased after treatment (1200KIU/ml) (P=0.003). The results of HCV viral load showed that liver dysfunction might be due to HCV activation. Conclusion: Our data show that HCV infection is not prognostic factor, but was the significantly influential for hepatic toxicity in the patients with DLBCL treated by RCHOP therapy. Further prospective studies are warranted to clear whether antiviral therapy should be added to rituximab and chemotherapy. Disclosures: Kinoshita: Chugai Pharmaceutical Co Ltd, Zenyaku Kogyo Co. Ltd: Honoraria; Zenyaku Kogyo Co. Ltd: Research Funding.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».