الفهرس 
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Abstract
It had been hypothesized that HCV might be involved in the
pathogenesis of B-cell NHL due to the close association between hepatitis
C virus (HCV) and essential mixed cryoglobulinemia (EMC), which is
considered an expression of a low-grade non-Hodgkin’s lymphoma
(NHL). That relationship between HCV infection and NHL lymphomas
has been a subject of intense research.
The aim of the study is to determine the prevalence of HCV
infection in the patients affected by B- and
its possible significance in the pathogenesis
and its effect on the outcome of the treatment.
The current study, was conducted on 200 patients presented with Bcell
non- -
confirmed and treated in Oncology department, Faculty of medicine,
Menoufiya university. NHLs were classified according to WHO
classification. All the patients were subjected for full history taking
clinical examination and routine staging procedures.
The patients were classified as 163 had DLBCL (81.5%) which
represented the majority of the patients ,23 had FL (13.4%) and 14 had
MZL (7.2%). HCV-RNA measured by RT-PCR was detected in (97/200
total subjects, 48.5%). 130 patients (65%) achieved complete response
(CR), 40 patients (20%) had partial response (PR). 11 patients had stable
disease and 19 patients(9.5%) had progressive disease. Hepatic toxicity
was registered in 45 patients (22.5%). With a follow-up of 12 months,
five patients had releapsed disease . RFS rate was 96.7%. With a followup
of 12 months , 20 patients died. 14 of the deaths (70%) were due to lymphoma progression , five hepatic failure and one other causes. OS rate
was 94.5%.
There was a non-significant differences between the two groups of
patients regarding response to treatment. Incidence of hepatic toxicity
observed more in patients with HCV infection but that was nonsignificant
stastically and HCV infection was not determined to be a
strong risk factor for this adverse effect . Incidence of severe hepatic
toxicity grade (3-4) was higher in HCV-positive patients. There was
statistically a high significant difference in response to treatment between
patients with hepatitic toxicity and those without as HCV-positive
patients who developed severe hepatic toxicity showed significantly less
response to the treatment used in NHL .There was a non-significant
relation between treatment and hepatic toxicity. The addition of rituximab
to chemotherapy regimens had a non-significant relation with hepatic
toxicity .There was stastically a non-significant difference between the
HCV-positive group and HCV- negative group as regard relapse , relapse
free survival, mortality and OS.