Clinical

Mixed cryoglobulinemia may increase risk of lymphoma and mortality

Last Updated: 2006-11-09 18:23:22 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Mixed cryoglobulinemia that is not associated with hepatitis C virus (HCV) is associated with an increased risk of lymphoma and death, according to a report in the October 23rd issue of the Archives of Internal Medicine.

"Patients with non-HCV-related mixed cryoglobulinemia have a four-fold increased risk of developing a non-Hodgkin's lymphoma," Dr. Patrice Cacoub from Hopital La Pitie-Salpetriere, Paris, told Reuters Health. These patients should therefore undergo a yearly check-up for complications."

Dr. Cacoub and colleagues investigated the characteristics and outcomes of 133 patients with persistent mixed cryoglobulinemia without HCV.

Twenty-nine (22%) of these 133 patients had B-cell non-Hodgkin's lymphoma, the authors report. After a mean follow-up of 49.4 months, 18 had died.

Sixty-five of the patients had non-HCV-related mixed cryoglobulinemia vasculitis, the results indicate. A quarter of these patients responded completely and just over half had a partial response to corticosteroids with or without immunosuppressants.

Thirteen of the 65 patients with non-HCV-related mixed cryoglobulinemia vasculitis died, the researchers note, and all 13 had renal involvement.

"The presence of mixed cryoglobulinemia vasculitis and hypogammaglobulinemia increased the odds of developing B-cell non-Hodgkin lymphoma 4.2-fold and 6.7-fold, respectively," the investigators write.

"Patients without HCV represent approximately 10% of the population with mixed cryoglobulinemia," the authors conclude. "Patients with non-HCV-related mixed cryoglobulinemia vasculitis have a poor outcome."

Arch Intern Med 2006;166:2101-2108.