Hermine Olivier, Lefrère François, Bronowicki Jean-Pierre, Mariette Xavier, Jondeau Katayoun, Eclache-Saudreau Virginie, Delmas Béatrice, Valensi Françoise, Cacoub Patrice, Brechot Christian, Varet Bruno, Troussard Xavier
Department of Hematology and Centre National de la Recherche Scientifique Unité Mixte de Recherche 8603, Hôpital Necker, Paris, France.
N Engl J Med. 2002 Jul 11;347(2):89-94. doi: 10.1056/NEJMoa013376.
Some epidemiologic studies suggest a link between hepatitis C virus (HCV) infection and some B-cell non-Hodgkin's lymphomas. We undertook this study after a patient with splenic lymphoma with villous lymphocytes had a hematologic response after antiviral treatment of HCV infection.
Nine patients who had splenic lymphoma with villous lymphocytes and HCV infection were treated with interferon alfa-2b (3 million IU three times per week) alone or in combination with ribavirin (1000 to 1200 mg per day). The outcomes were compared with those of six similarly treated patients with splenic lymphoma with villous lymphocytes who tested negative for HCV infection.
Of the nine patients with HCV infection who received interferon alfa, seven had a complete remission after the loss of detectable HCV RNA. The other two patients had a partial and a complete remission after the addition of ribavirin and the loss of detectable HCV RNA. One patient had a relapse when the HCV RNA load again became detectable in blood. In contrast, none of the six HCV-negative patients had a response to interferon therapy.
In patients with splenic lymphoma with villous lymphocytes who are infected with HCV, treatment with interferon can lead to regression of the lymphoma.
一些流行病学研究表明丙型肝炎病毒(HCV)感染与某些B细胞非霍奇金淋巴瘤之间存在联系。在一名伴有绒毛状淋巴细胞的脾淋巴瘤患者经HCV感染抗病毒治疗后出现血液学反应后,我们开展了这项研究。
9例伴有绒毛状淋巴细胞的脾淋巴瘤且感染HCV的患者接受了单独使用干扰素α-2b(300万国际单位,每周3次)或联合利巴韦林(每天1000至1200毫克)的治疗。将结果与6例同样接受治疗但HCV感染检测呈阴性的伴有绒毛状淋巴细胞的脾淋巴瘤患者的结果进行比较。
在接受干扰素α治疗的9例HCV感染患者中,7例在检测不到HCV RNA后完全缓解。另外2例患者在加用利巴韦林且检测不到HCV RNA后分别部分缓解和完全缓解。1例患者在血液中再次检测到HCV RNA负荷时复发。相比之下,6例HCV阴性患者中无一例对干扰素治疗有反应。
在感染HCV的伴有绒毛状淋巴细胞的脾淋巴瘤患者中,干扰素治疗可导致淋巴瘤消退。