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Blood, 1 January 2005, Vol. 105, No. 1, pp. 74-76.
Prepublished online as a Blood First Edition Paper on September 7, 2004; DOI 10.1182/blood-2004-05-1711.
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CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Brief report
Splenic lymphoma with villous lymphocytes, associated with type II cryoglobulinemia and HCV infection: a new entity?
David Saadoun,
Felipe Suarez,
François Lefrere,
Françoise Valensi,
Xavier Mariette,
Achille Aouba,
Caroline Besson,
Bruno Varet,
Xavier Troussard,
Patrice Cacoub, and
Oliver Hermine
From the Department of Hematology, Hôpital Necker, Paris, France; Department of Rheumatology, Hôpital de Kremlin-Bicêtre, Le Kremlin-Bicêtre, France; Department of Hematology, CHU Côte de Nacre, Caen, France; and Department of Internal Medicine, Hôpital Pitié-Salpétrière, Paris, France.
Hepatitis C virus (HCV) has been associated with the development of B-cell non-Hodgkin lymphomas. We recently reported the regression of splenic lymphoma with villous lymphocytes (SLVL) in patients with HCV after antiviral treatment, demonstrating a direct role of HCV in lymphomagenesis. This study expands our previous results in 18 patients with chronic HCV and SLVL. Mixed cryoglobulinemia (MC) was present in all cases and was symptomatic in 13 (72%). All patients were treated with interferon alone or in association with ribavirin. Hematologic and virologic responses were correlated. Fourteen (78%) patients achieved a sustained complete hematologic response after clearance of HCV RNA. Two patients had a virologic partial response and achieved a complete hematologic response. Two virologic nonresponders achieved partial hematologic response. Regardless of the response, monoclonal immunoglobulin gene rearrangement persisted after treatment. This study underscores the role of HCV in the lymphomagenesis and the benefit of antiviral treatment for patients presenting with HCV-driven lymphoproliferations.
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