Reuters Health Information (2005-02-08): Antiviral treatment seems effective in low-grade, HCV-associated NHL
Antiviral treatment seems effective in low-grade, HCV-associated NHL
Last Updated: 2005-02-08 12:46:19 -0400 (Reuters Health)
NEW YORK (Reuters Health) - The largest series to date
evaluating antiviral treatment in patients with hepatitis C-related
low-grade B-cell non-Hodgkin's lymphoma (NHL) shows it can be helpful
in some cases. Anti-HCV treatment produced a complete response in 7 of
12 such patients, and hematological response was closely tied to
reduction or clearing of viral load.
HCV has been linked to hepatocellular carcinoma and B-cell NHL, Dr.
Daniele Vallisa of G. da Saliceto Hospital in Placenza, Italy, and
colleagues note, but it is not clear how the virus might contribute to
the disease. Antiviral treatment has shown success in treating
cryoglobulinemia and splenic lymphoma, while interferon has shown
antitumor effects in lymphoma not associated with HCV infection.
In the current study, the researchers tested a regimen of pegylated
interferon and ribavirin in 13 patients with low-grade B-NHL and HCV
infection. All had an indolent course of disease, meaning they had no
bulky disease and tumor doubling time was a year or longer. Patients
were evaluated at six and twelve months.
Patients weighing under 60 kg were given 50 micrograms of pegylated
interferon alfa 2-beta subcutaneously once weekly, and took 1,000 mg of
ribavirin once daily; heavier patients were given 70 micrograms of
interferon and 1,200 mg of ribavirin.
At six months treatment was stopped if complete hematologic response
with viral clearance had occurred or if there was no response. If there
was partial response, treatment was continued for an additional six
Two of the patients had serious adverse effects and had to halt
treatment. Treatment could be evaluated in 12 patients. Seven had a
complete response, two had a partial response, two had stable disease
and one showed progressive disease.
The researchers conclude: "The indolent course of a low-grade B-cell
lymphoma in the setting of HCV infection should be an indication for
initiation of antiviral treatment, both in genotype 1 and 2, and
systemic viremia evaluation may be seen as a predictor of clinical
J Clin Oncol 2005;23:468-473.