HCV‐associated B‐cell non‐Hodgkin lymphomas and new direct antiviral agents. (15th July 2015)

• Record Type: Journal Article
• Authors: Carrier, Paul; Jaccard, Arnaud; Jacques, Jérémie; Tabouret, Tessa; Debette‐Gratien, Marilyne; Abraham, Julie; Mesturoux, Laura; Marquet, Pierre; Alain, Sophie; Sautereau, Denis; Essig, Marie; Loustaud‐Ratti, Véronique
• Is Part Of: Liver international. Volume 35:Number 10(2015:Oct.)
• Page Start: 2222
• Page End: 2227
• Publication Date: 2015-07-15
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.12897
• Languages: English
• ISSNs: 1478-3223

Abstract

<abstract abstract-type="main" id="liv12897-abs-0001"> <title>Abstract</title> <sec id="liv12897-sec-0001" sec-type="section"> <title>Background & Aims</title> <p>Hepatitis C virus‐related B‐cell proliferation is a model of virus‐driven autoimmune/neoplastic disorder leading to mixed cryoglobulinaemia and/or B‐cell non‐Hodgkin lymphoma. These lymphomas are often marginal zone lymphomas or diffuse large B‐cell lymphomas. Peginterferon/Ribavirin therapy has proved its crucial role in the cure of these non‐Hodgkin lymphomas, but data are lacking concerning new direct anti‐viral agents.</p> </sec> <sec id="liv12897-sec-0002" sec-type="section"> <title>Methods</title> <p>We report five cases of Hepatitis C virus‐associated B‐cell non‐Hodgkin lymphoma treated with direct anti‐viral agents: two marginal zone lymphomas received direct anti‐viral agents alone (one with a leukaemic phase only, one with splenic and deep lymph nodes localizations); one renal marginal zone lymphoma with renal insufficiency received direct anti‐viral agents and four rituximab infusions simultaneously; two diffuse large B‐cell lymphomas were treated with direct ant‐viral agents following chemotherapy.</p> </sec> <sec id="liv12897-sec-0003" sec-type="section"> <title>Results</title> <p>Sustained virological response was obtained in all patients, and complete remission of NHL was noted 6 months after cessation of any treatment except for one patient with a persistent small leukaemic phase.</p> </sec> <sec id="liv12897-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Direct anti‐viral agents might be proposed as a first‐line treatment in marginal zone lymphomas in the case of no life‐threatening complications with the precaution of a long‐term follow‐up. In the setting of diffuse large B‐cell lymphomas, well‐tolerated direct anti‐viral agents could potentially be introduced very early not only to prevent relapse of these lymphomas but also to limit the liver toxicity of chemotherapy and rituximab by preventing outbreaks of viral load. New observations and trials should support these assumptions.</p> </sec> </abstract>