title: HCV-associated B-cell non-Hodgkin lymphomas and new direct antiviral agents.
abstract: OBJECTIVE
  Hepatitis C virus-related B-cell proliferation is a model of virus-driven autoimmune/neoplastic disorder leading to mixed cryoglobulinaemia and/or B-cell non-Hodgkin lymphoma. These lymphomas are often marginal zone lymphomas or diffuse large B-cell lymphomas. Peginterferon/Ribavirin therapy has proved its crucial role in the cure of these non-Hodgkin lymphomas, but data are lacking concerning new direct anti-viral agents.
  
  
  METHODS
  We report five cases of Hepatitis C virus-associated B-cell non-Hodgkin lymphoma treated with direct anti-viral agents: two marginal zone lymphomas received direct anti-viral agents alone (one with a leukaemic phase only, one with splenic and deep lymph nodes localizations); one renal marginal zone lymphoma with renal insufficiency received direct anti-viral agents and four rituximab infusions simultaneously; two diffuse large B-cell lymphomas were treated with direct ant-viral agents following chemotherapy.
  
  
  RESULTS
  Sustained virological response was obtained in all patients, and complete remission of NHL was noted 6 months after cessation of any treatment except for one patient with a persistent small leukaemic phase.
  
  
  CONCLUSIONS
  Direct anti-viral agents might be proposed as a first-line treatment in marginal zone lymphomas in the case of no life-threatening complications with the precaution of a long-term follow-up. In the setting of diffuse large B-cell lymphomas, well-tolerated direct anti-viral agents could potentially be introduced very early not only to prevent relapse of these lymphomas but also to limit the liver toxicity of chemotherapy and rituximab by preventing outbreaks of viral load. New observations and trials should support these assumptions.
authors.affiliation: Service d'Hépato-gastroentérologie, CHU Limoges, Limoges, France.|U850 INSERM, Univ. Limoges, CHU Limoges, Limoges, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Carrier
authors.affiliation: Service d'Hématologie Clinique CHU Limoges, Limoges, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Jaccard
authors.affiliation: Service d'Hépato-gastroentérologie, CHU Limoges, Limoges, France.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Jacques
authors.affiliation: Service d'Hépato-gastroentérologie, CHU Limoges, Limoges, France.
authors.forename: Tessa
authors.initials: T
authors.lastname: Tabouret
authors.affiliation: Service d'Hépato-gastroentérologie, CHU Limoges, Limoges, France.|U850 INSERM, Univ. Limoges, CHU Limoges, Limoges, France.
authors.forename: Marilyne
authors.initials: M
authors.lastname: Debette-Gratien
authors.affiliation: Service d'Hématologie Clinique CHU Limoges, Limoges, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Abraham
authors.affiliation: Service d'Anatomopathologie CHU Limoges, Limoges, France.
authors.forename: Laura
authors.initials: L
authors.lastname: Mesturoux
authors.affiliation: U850 INSERM, Univ. Limoges, CHU Limoges, Limoges, France.|Service de Pharmacologie, CHU Limoges, Limoges, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Marquet
authors.affiliation: U850 INSERM, Univ. Limoges, CHU Limoges, Limoges, France.|U1092 INSERM, Univ. Limoges, CHU Limoges, Limoges, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Alain
authors.affiliation: Service d'Hépato-gastroentérologie, CHU Limoges, Limoges, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Sautereau
authors.affiliation: U850 INSERM, Univ. Limoges, CHU Limoges, Limoges, France.|Service de Néphrologie Dialyse Transplantation, CHU de Limoges, Limoges, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Essig
authors.affiliation: Service d'Hépato-gastroentérologie, CHU Limoges, Limoges, France.|U850 INSERM, Univ. Limoges, CHU Limoges, Limoges, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Loustaud-Ratti
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D016174:Hepacivirus / Q000187:drug effects; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D012189:Retrospective Studies; D000069283:Rituximab / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D000069283:Rituximab
keywords: B-cell lymphoma; direct anti-viral agents; hepatitis C