Clinical

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 months.

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 response."

J Clin Oncol 2005;23:468-473.