Regression of lymphoproliferative disorder after treatment for hepatitis C virus infection in a patient with partial trisomy 3, Bcl-2 overexpression, and type II cryoglobulinemia.
A patient with type II cryoglobulinemic vasculitis and hepatitis C virus (HCV) infection presented with a leukemiclike proliferation of B cells bearing marginal zone B-cell phenotypic markers. A partial trisomy 3 (bands 3q11-29) and overexpression of Bcl-2 without t(14;18) translocation was detected in the monoclonal B cells that were classic rheumatoid factor-producing B cells bearing the WA cross-idiotype. Treatment with interferon-alpha produced a complete clinical remission and synchronous marked decreases in viremia and monoclonal B-cell prevalence. This is the first report of partial trisomy 3 and Bcl-2 overexpression in type II cryoglobulinemic vasculitis associated with HCV infection. Further studies of HCV-infected patients with and without type II cryoglobulinemia are required to determine the prevalence and possible physiologic and/or pathophysiologic significance of these findings.
Casato
Milvia
M
Department of Clinical Medicine, University of Rome La Sapienza, Rome, Italy.
Mecucci
Cristina
C
Agnello
Vincent
V
Fiorilli
Massimo
M
Knight
Glenn B
GB
Matteucci
Caterina
C
Gao
Lei
L
Kay
Jonathan
J
D002893:Chromosomes, Human, Pair 3; D003449:Cryoglobulinemia / Q000188:drug therapy / Q000209:etiology / Q000821:virology*; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000188:drug therapy / Q000209:etiology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D016896:Treatment Outcome; D014314:Trisomy; D014657:Vasculitis / Q000188:drug therapy / Q000209:etiology / Q000821:virology
D019253:Proto-Oncogene Proteins c-bcl-2