Characterization of B-cell lymphoma in patients with hepatitis C virus infection

F Mizorogi,MD,^a J Hiramoto,MD,^b A Nozato,MD,^a S Fukumi,MD,^a T Shimada,MD,^a M Kobayashi,MD^a

AIM: Hepatitis C virus (HCV)-seropositive non-Hodgkin's lymphoma (NHL) has not been extensively investigated in Japan. We studied the clinical features and outcomes of HCV-seropositive patients with NHL. METHODS: Retrospective chart review. RESULTS: HCV infection was detected in 26 patients of 196 with NHL. The male:female ratio was 17:9, and median age was 67(48-85) years old at the NHL diagnosis. In clinical past history, 14 received blood transfusion, 5 had cancer except for lymphoma or hepatocellular carcinoma, and 9 had tuberculosis. All patients had B-cell lymphoma. According to Working Formulation, 7 had low grade, and 14 had intermediate grade, including 13 of diffuse large B cell lymphoma. Twenty patients were in clinical stage IV. Primary extranodal NHL was determined in 13 patients including in 4 primary hepatic lymphoma. Four patients were asymptotic HCV carrier, 13 had chronic hepatitis, 9 liver cirrhosis including 4 hepatocellular carcinoma. Twenty patients received chemotherapy, and 17 obtained complete response. Five patients died of hepatocellular carcinoma, 6 of hepatic insufficiency , 2 of lymphoma , 1 of stroke, lung tuberculosis, and unknown cause. CONCLUSION: Response rate and short-term prognosis is not likely to be affected HCV infection, while in long-term prognosis, main cause of death was liver related event. Further investigation is warranted by elucidating the relationship between HCV and lymphoma, and by development of treatment strategy in HCV-positive lymphoma. Japan Oncology Group is currently conducting the phase II trial to evaluate the CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) regimen for HCV-positive patients with NHL.

KEY WORDS: lymphoma, B-cell, hepatitis C virus.

For more information, contact fumi@jikei.ac.jp

Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Viral Oncogenesis.

http://www.cancerprev.org/Journal/Issues/26/101/996/4333