J Hematol

Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc

Journal website http://www.thejh.org

Original Article

Volume 2, Number 1, June 2013, pages 14-21

Efficacy of Ribavirin to Prevent Hepatitis Reactivation in Hepatitis C Virus-Infected Patients Treated for Non-Hodgkin Lymphoma, Single Egyptian Center Study

**Table 1.** Patient Characteristics of the Studied Groups
Variable	HCV +ve patients	HCV-ve patients Group C (33) No (%)	P-value
LN: Lymphadenopathy; DLBCL: diffuse large B-cell lymphoma; IPI: International Prognostic Index.
Age (years)	Mean ± SD	45 ± 15.9	52 ± 6.5	49 ± 13.7	0.496
Sex	Male	6 (54.5%)	5 (38.5%)	19 (57.7%)	0.50
	Female	5 (45.5%)	8 (61.5%)	14 (42.4%)
PS	PS = 0.1	10(90.9% )	11(84.6% )	29 (87.9% )	0.895
	PS = 2	1 (9.1% )	2 (15.4% )	4 (12.1% )
Clinical	LN(only)	7 (63.6%)	6 (46.2%)	20 (60.6%)	0.424
	Splenomegaly	3 (27.3%)	5 (38.5%)	5 (15.2%)
	Extranodal	1 (9.1%)	2 (15.4%)	8 (24.2%)
Stage	I	0 (0 %)	1 (7.7%)	4 (12.1%)	0.224
	II	2 (18.2%)	3 (23.1%)	15 (45.5%)
	III	4 (36.4%)	6 (46.2%)	9 (27.3%)
	IV	5 (45.5%)	3 (23.1%)	5 (15.2%)
LDH	Normal	0 (0 %)	0 (0 %)	2 (6.1 %)	0.471
	High (234)	11 (100%)	13 (100%)	31 (90.9%)
IPI	Low risk	1 (9.1%)	3 (23.1%)	11 (33.3%)	0.572
	Low-intermediate risk	8 (72.7%)	8 (61.5%)	18 (54.5%)
	High intermediate risk	2 (18.2%)	2 (15.4%)	3 (9.1%)
	High risk	0 (0 %)	0 (0 %)	1 (3.0%)
Pathology	DLBCL	8 (72.7%)	7 (53.8%)	24 (72.7%)	0.130
	Indolent NHL	3 (27.3%)	6 (46.2%)	5 (15.2%)
	- marginal zone lymphoma	1 (9%)	2 (15.3%)	0 (0%)
	- small lymphocytic lymphoma	0 (0%)	3 (23%)	4 (12.1%)
	- Mantle cell lymphoma	1 (9%)	1 (7.6%)	1 (3%)
	- Lymphoplasmacytic lymphoma	1 (9%)	0 (0%)	0 (0%)
	Burkitt	0 (0%)	0 (0%)	4 (12.1%)
Chemotherapy	CHOP	8 (72.7%)	7 (53.8%)	24 (72.7%)	0.165
	-COP	3 (27.3%)	5 (38.5%)	5 (15.2%))
	-Hyper CVAD	0 (0%)	0(0 %)	4 (12.1%)
	-FC	0 (0%)	1 (7.7%)	0 (0%)

Table 1. Patient Characteristics of the Studied Groups

Variable

HCV +ve patients

HCV-ve patients Group C (33) No (%)

P-value

Received Ribavirin Group A (11) No (%)

Without Ribavirin Group B (13) No (%)

LN: Lymphadenopathy; DLBCL: diffuse large B-cell lymphoma; IPI: International Prognostic Index.

Age (years)

Mean ± SD

45 ± 15.9

52 ± 6.5

49 ± 13.7

0.496

Sex

Male

6 (54.5%)

5 (38.5%)

19 (57.7%)

0.50

Female

5 (45.5%)

8 (61.5%)

14 (42.4%)

PS = 0.1

10(90.9% )

11(84.6% )

29 (87.9% )

0.895

PS = 2

1 (9.1% )

2 (15.4% )

4 (12.1% )

Clinical

LN(only)

7 (63.6%)

6 (46.2%)

20 (60.6%)

0.424

Splenomegaly

3 (27.3%)

5 (38.5%)

5 (15.2%)

Extranodal

1 (9.1%)

2 (15.4%)

8 (24.2%)

Stage

0 (0 %)

1 (7.7%)

4 (12.1%)

0.224

2 (18.2%)

3 (23.1%)

15 (45.5%)

III

4 (36.4%)

6 (46.2%)

9 (27.3%)

5 (45.5%)

3 (23.1%)

5 (15.2%)

LDH

Normal

0 (0 %)

2 (6.1 %)

0.471

High (234)

11 (100%)

13 (100%)

31 (90.9%)

IPI

Low risk

1 (9.1%)

3 (23.1%)

11 (33.3%)

0.572

Low-intermediate risk

8 (72.7%)

8 (61.5%)

18 (54.5%)

High intermediate risk

2 (18.2%)

2 (15.4%)

3 (9.1%)

High risk

0 (0 %)

1 (3.0%)

Pathology

DLBCL

8 (72.7%)

7 (53.8%)

24 (72.7%)

0.130

Indolent NHL

3 (27.3%)

6 (46.2%)

5 (15.2%)

- marginal zone lymphoma

1 (9%)

2 (15.3%)

0 (0%)

- small lymphocytic lymphoma

0 (0%)

3 (23%)

4 (12.1%)

- Mantle cell lymphoma

1 (9%)

1 (7.6%)

1 (3%)

- Lymphoplasmacytic lymphoma

1 (9%)

0 (0%)

Burkitt

0 (0%)

4 (12.1%)

Chemotherapy

CHOP

8 (72.7%)

7 (53.8%)

24 (72.7%)

0.165

-COP

3 (27.3%)

5 (38.5%)

5 (15.2%))

-Hyper CVAD

0 (0%)

0(0 %)

4 (12.1%)

-FC

0 (0%)

1 (7.7%)

0 (0%)

**Table 2.** Comparison Between HCV + ve Patients Who Received Ribavirin (Group A) Versus Those Did Not Receive Ribavirin (Group B) Regarding Hepatic Enzyme Flare and HCV PCR Reactivation
Variable	HCV + ve patients	P value
Enzyme flare:			0.605
No	8, 72.7	9, 69.2
Yes	3, 27.3	4, 30.8
PCR reactivation:			0.585
No	9, 81.8	10, 76.9
Yes	2, 18.2	3, 23.1

Table 2. Comparison Between HCV + ve Patients Who Received Ribavirin (Group A) Versus Those Did Not Receive Ribavirin (Group B) Regarding Hepatic Enzyme Flare and HCV PCR Reactivation

Variable

HCV + ve patients

P value

Received Ribavirin (11) No (%)

Without Ribavirin (13) No (%)

Enzyme flare:

0.605

8, 72.7

9, 69.2

Yes

3, 27.3

4, 30.8

PCR reactivation:

0.585

9, 81.8

10, 76.9

Yes

2, 18.2

3, 23.1

**Table 3.** Frequency Treatment Disruption Among the Studied Groups of Patients According to Hepatic Enzyme Flare
Variable	Hepatic enzyme flare	P value
Chemotherapy course:			0.002*
-completed	49, 100	5, 62.5
-stopped	0, 0	3, 37.5

Table 3. Frequency Treatment Disruption Among the Studied Groups of Patients According to Hepatic Enzyme Flare

Variable

Hepatic enzyme flare

P value

No enzyme flare (49) No (%)

With enzyme flare (8) No (%)

Chemotherapy course:

0.002*

-completed

49, 100

5, 62.5

-stopped

0, 0

3, 37.5

**Table 4.** Relation Between HCV PCR Reactivation in NHL Patients With HCV + ve and Hepatic Enzyme Flare
Variable	HCV + ve NHL patients	P value
Enzyme flare:			< 0.001*
No	17, 89.5	0, 0
Yes	2, 10.5	5, 100

Table 4. Relation Between HCV PCR Reactivation in NHL Patients With HCV + ve and Hepatic Enzyme Flare

Variable

HCV + ve NHL patients

P value

No HCV PCR reactivation No (19) %

With HCV PCR reactivation No (5) %

Enzyme flare:

< 0.001*

17, 89.5

0, 0

Yes

2, 10.5

5, 100

**Table 5.** Distribution of Treatment Response Among the Studied Groups of Patients According to HCV Status
Response	HCV + ve patients	HCV-ve patients Group C (33) No (%)	P value
Responders				0.329
Complete	8, 72.7	6, 46.2	22, 66.7
Non-responders	3, 27.3	7, 53.8	11, 33.3
Partial	3, 27.3	5, 38.5	8, 24.2
Stable	0, 0.0	1, 7.7	3, 9.1
Progression	0, 0.0	1, 7.7	0, 0.0
Total	11, 100	13, 100	33, 100

Table 5. Distribution of Treatment Response Among the Studied Groups of Patients According to HCV Status

Response

HCV + ve patients

HCV-ve patients Group C (33) No (%)

P value

Received Ribavirin Group A (11) No (%)

Without Ribavirin Group B (13) No (%)

Responders

0.329

Complete

8, 72.7

6, 46.2

22, 66.7

Non-responders

3, 27.3

7, 53.8

11, 33.3

Partial

3, 27.3

5, 38.5

8, 24.2

Stable

0, 0.0

1, 7.7

3, 9.1

Progression

0, 0.0

1, 7.7

0, 0.0

Total

11, 100

13, 100

33, 100