Blood, Vol. 91 No. 1 (January 1), 1998:
pp. 360-360
CORRESPONDENCE
Chronic Hepatitis C Virus and Gastric MALT Lymphoma
 |
LETTER |
To the Editor:
Cases of lymphocytic monoclonal B-cell proliferation such as
non-Hodgkin's lymphomas have been reported in chronically hepatitis C
virus (HCV)-infected patients. Lymphomas of the mucosa-associated
lymphoid tissue (MALT) type are due to monoclonal
proliferation of B cells showing characteristic histopathological
features of MALT. Luppi et al1 recently reported an
unexpectedly high prevalence of HCV infection in a series of patients
with low-grade lymphomas of the MALT type in various body sites. This
study showed the presence of both anti-HCV antibodies and HCV-RNA
in the serum of 8 of 16 MALT lymphoma patients (50%).1 In
another study, Pioltelli et al2 also observed a high
prevalence of HCV infection in low-grade lymphomas of the MALT type
(36.4%), although they did not mention the number of cases examined.
The aim of the present study was to assess the prevalence of HCV
infection in a well-characterized series of 46 patients with gastric
MALT lymphoma. Of the 46 patients, 25 had a low-grade lymphoma (14
women, 11 men, mean age 54.2 years, range 30 to 75) and 21 had a
high-grade lymphoma (8 women, 13 men, mean age 56.3 years, range 23 to
85). Helicobacter pylori infection was demonstrated by
serological and/or histological tests in 37 of 46 patients
(80.4%). One hundred sixty-five patients with gastroduodenal disease
were recruited to compose the control group. There were 84 patients
with duodenal ulcer, 43 with gastric ulcer, and 38 with dyspepsia. The
two groups were comparable in terms of the sex ratio, age, prevalence
of H pylori, risk factors for HCV infection (previous
parenteral exposure to blood products, intravenous drug misuse,
nosocomial exposure), and geographical origin. Diagnosis of gastric
MALT lymphoma was based on gastric biopsy specimens evaluated according
to Isaacson's classification3 and by immunophenotypic
analysis of surface T- and B-lymphocyte markers. Anti-HCV antibodies
were determined by third-generation enzyme-linked immunosorbent assay
and confirmed by third-generation recombinant immunoblot assay (RIBA)
in all patients (Ortho Clinical Systems, Raritan, NJ). There was no
significant difference between the prevalence of HCV infection in the
MALT lymphoma group and the control group: among the patients with
gastric MALT lymphoma, only 1 had anti-HCV antibodies (2.2%), compared
with 4 in the control group (2.4%) (not significant). The
only MALT patient who tested anti-HCV Ab-positive was also positive for
H pylori and belonged to the low-grade MALT lymphoma group.
Thus, we found no higher prevalence of HCV infection among patients
with gastric MALT lymphoma than in a control group composed of subjects
with a gastroduodenal disease similarly related to H pylori
infection, with the same risk factors for hepatitis C and deriving from
the same geographical region. Our data contrast with those of the
Italian teams1,2 and are more in keeping with those of the
American and British teams,4,5 who did not specifically
study gastric MALT lymphoma but found no evidence of a relationship
between HCV infection and non-Hodgkin's lymphoma.
To our knowledge, this is the first study to evaluate the prevalence of
HCV infection in a large, well-characterized series of patients with
gastric lymphomas of the MALT type. Our results indicate that there is
no link between HCV infection and gastric MALT lymphoma in
France.
El Mostafa Tkoub
Corinne Haioun
Jean Michel Pawlotsky
Daniel Dhumeaux
Jean Charles
Delchier
Services d'Hématologie
Services
d'Hépatogastroentérologie
de Virologie
Hôpital
Henri Mondor
Créteil, France
| |
REFERENCES |
1.
Luppi M,
Longo G,
Grazia Ferrari M,
Ferrara L,
Marasca R,
Barozzi P,
Morselli M,
Emilia G,
Torelli G:
Additional neoplasms and HCV infection in low-grade lymphoma of MALT type.
Br J Haematol
94:363,
1996
2. (letter)
Pioltelli P,
Zehender G,
Monti G,
Monteverde A,
Galli M:
HCV and non-Hodgkin lymphoma.
Lancet
347:624,
1996[Medline]
[Order article via Infotrieve]
3. Isaacson PG, Norton AJ: Extranodal lymphomas: Malignant lymphoma
of the gastrointestinal tract, in Extranodal Lymphomas. Edinburgh, UK,
Churchill Livingstone, 1994, p 15
4. (abstr)
King PD,
Wilkes JD,
Herteen CM:
Non-Hodgkin's lymphoma in the USA is not associated with hepatitis C infection.
Gastroenterology
112:1304a,
1997
5. (letter)
Hanley J,
Jarvis L,
Simmonds P,
Parker A,
Ludlam C:
HCV and non-Hodgkin lymphoma.
Lancet
347:1339,
1996[Medline]
[Order article via Infotrieve]
