Role of anti-hepatitis C virus (HCV) treatment in HCV-related, low-grade, B-cell, non-Hodgkin's lymphoma: a multicenter Italian experience.
OBJECTIVE
Hepatitis C virus (HCV) is endemic in some areas of Northwestern Europe and the United States. HCV has been shown to play a role in the development of both hepatocellular carcinoma and B-cell non-Hodgkin's lymphoma (B-NHL). The biologic mechanisms underlying the lymphomagenic activity of the virus so far are under investigation. In this study, the role of antiviral (anti-HCV) treatment in B-NHL associated with HCV infection is evaluated.


METHODS
Thirteen patients with histologically proven low-grade B-NHL characterized by an indolent course (ie, doubling time no less than 1 year, no bulky disease) and carrying HCV infection were enrolled on the study. All patients underwent antiviral treatment alone with pegilated interferon and ribavirin. Response assessment took place at 6 and 12 months.


RESULTS
Of the twelve assessable patients, seven (58%) achieved complete response and two (16%) partial hematologic response at 14.1 +/- 9.7 months (range, 2 to 24 months, median follow-up, 14 months), while two had stable disease with only one patient experiencing progression of disease. Hematologic responses (complete and partial, 75%) were highly significantly associated to clearance or decrease in serum HCV viral load following treatment (P = .005). Virologic response was more likely to be seen in HCV genotype 2 (P = .035), while hematologic response did not correlate with the viral genotype. Treatment-related toxicity did not cause discontinuation of therapy in all but two patients, one of whom, however, achieved complete response.


CONCLUSIONS
This experience strongly provides a role for antiviral treatment in patients affected by HCV-related, low-grade, B-cell NHL.
Vallisa
Daniele
D
Department of Oncology and Hematology, G. da Saliceto Hospital, Piacenza, Via Taverna 49, 29100 Piacenza, Italy. d.vallisa@ausl.pc.it
Bernuzzi
Patrizia
P
Arcaini
Luca
L
Sacchi
Stefano
S
Callea
Vittorio
V
Marasca
Roberto
R
Lazzaro
Antonio
A
Trabacchi
Elena
E
Anselmi
Elisa
E
Arcari
Anna Lisa
AL
Moroni
Carlo
C
Bertè
Raffaella
R
Lazzarino
Mario
M
Cavanna
Luigi
L
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000472:pathogenicity*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000494:pharmacology / Q000627:therapeutic use*; D016393:Lymphoma, B-Cell / Q000628:therapy* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011379:Prognosis; D011446:Prospective Studies; D011994:Recombinant Proteins; D012254:Ribavirin / Q000494:pharmacology / Q000627:therapeutic use*; D019562:Viral Load
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b