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丙型肝炎感染与肝毒性相关,但不影响接受基于利妥昔单抗的化疗治疗的弥漫性大 B 细胞淋巴瘤患者的生存。

Hepatitis C infection is associated with hepatic toxicity but does not compromise the survival of patients with diffuse large B cell lymphoma treated with rituximab-based chemotherapy.

机构信息

Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung 40402, Taiwan.

Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung 40402, Taiwan; Cancer Center, China Medical University Hospital, Taichung 40402, Taiwan; College of Medicine, School of Medicine, China Medical University, Taichung 40402, Taiwan.

出版信息

Leuk Res. 2015 Feb;39(2):151-6. doi: 10.1016/j.leukres.2014.11.015. Epub 2014 Nov 29.

Abstract

The influence of hepatitis C virus (HCV) infection on the outcome of patients with diffuse large B cell lymphoma (DLBCL) treated with rituximab-based chemotherapy is controversial. We retrospectively analyzed the characteristics and clinical outcomes of 168 patients with DLBCL diagnosed between January 2005 and December 2011. Twenty-nine patients who were HCV-positive before lymphoma treatment were compared with 139 patients who did not have HCV infection. The median follow-up duration was 3.0 (0.07-8.02) years. HCV infection resulted in more hepatic toxicity in both univariate (p=0.001) and multivariate (p=0.003) analyses. In addition, HCV-positive DLBCL patients were more likely to have treatment delay (20.1% vs. 0.7%, p<0.001). For patients who developed hepatic toxicity during immunochemotherapy, HCV-positive patients had significantly higher folds of aspartate aminotransferase elevation (p=0.042) and total bilirubin elevation (p=0.012) compared with those who were HCV negative. However, HCV did not influence the 5-year progression-free survival rate (p=0.412) or 5-year overall survival rate (p=0.410). In conclusion, HCV infection is associated with increased hepatic toxicity and delayed chemotherapy without compromised survival in DLBCL patients treated with rituximab-based chemotherapy.

摘要

丙型肝炎病毒 (HCV) 感染对接受利妥昔单抗为基础的化疗的弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者结局的影响存在争议。我们回顾性分析了 168 例 2005 年 1 月至 2011 年 12 月期间诊断为 DLBCL 的患者的特征和临床结局。将 29 例在淋巴瘤治疗前 HCV 阳性的患者与 139 例未感染 HCV 的患者进行比较。中位随访时间为 3.0(0.07-8.02)年。HCV 感染在单变量(p=0.001)和多变量(p=0.003)分析中均导致更严重的肝毒性。此外,HCV 阳性的 DLBCL 患者更有可能出现治疗延迟(20.1%比 0.7%,p<0.001)。对于在免疫化疗期间发生肝毒性的患者,HCV 阳性患者的天冬氨酸转氨酶升高倍数(p=0.042)和总胆红素升高倍数(p=0.012)显著高于 HCV 阴性患者。然而,HCV 并未影响 5 年无进展生存率(p=0.412)或 5 年总生存率(p=0.410)。总之,在接受利妥昔单抗为基础的化疗的 DLBCL 患者中,HCV 感染与肝毒性增加和化疗延迟相关,但不影响生存。

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