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Blood, 15 March 2002, Vol. 99, No. 6, pp. 2259-2261
BRIEF REPORT
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
Milvia Casato,
Cristina Mecucci,
Vincent Agnello,
Massimo Fiorilli,
Glenn B. Knight,
Caterina Matteucci,
Lei Gao, and
Jonathan Kay
From the Department of Clinical Medicine, University of Rome La
Sapienza, Rome, Italy; Hematology, University of Perugia, Italy; Lahey
Clinic, Burlington, MA; Veterans Affairs Medical Center, Bedford, MA.
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- 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.
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