Clinical Characteristics and Management of Patients With Concomitant Liver Cirrhosis and Lymphoma: A Systematic Review

Jelena Jelicic*, Thomas Stauffer Larsen, Annette Dam Fialla, Zoran Bukumiric, Bosko Andjelic

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


Over the years, a rising incidence of liver cirrhosis and lymphoma has been observed. Therefore, the risk of having cirrhosis as a comorbidity increases, thus challenging treatment approaches as data on the management of these patients is lacking. We performed a systematic review to summarize papers that analyzed patients with liver cirrhosis that occurred before and/or concomitantly to lymphoma. We identified 153 papers (230 patients) through Pubmed and/or Embase search. Publications comprised predominantly of case reports and/or case series. Most patients had HCV-related cirrhosis (62.6%), and aggressive lymphoma histology (59.6%). Data on liver status was available in 55.7% of all patients, with 46.1% having decompensated liver cirrhosis. These patients experienced more often treatment reductions and/or modifications, treatment side effects, and inferior survival than those with compensated cirrhosis (median 18 months vs. median not reached). Dose reductions and/or treatment modifications primarily due to concomitant liver disease were common. Moreover, liver toxicity was observed in 33.6% of patients with provided information on treatment side effects, ranging from mild toxicity to liver failure with fatal outcomes. Again, despite treatment modification/reduction, patients with decompensated liver cirrhosis developed hepatic toxicity more frequently than patients with compensated liver disease. Although patients suffering from cirrhosis and lymphoma can tolerate standard chemoimmunotherapy, a cautious multidisciplinary approach is needed to evaluate the risks and benefits.

Original languageEnglish
JournalClinical Lymphoma Myeloma and Leukemia
Issue number11
Pages (from-to)e981-e991
Publication statusPublished - Nov 2022


  • Child-Pugh score
  • Cirrhosis
  • Liver
  • Lymphoma
  • Treatment
  • Liver Cirrhosis/complications
  • Lymphoma/complications
  • Humans
  • Liver Failure
  • Incidence


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