Aksoy S, Abali H, Kilickap S, Erman M, Kars A
Hacettepe University Institute of Oncology, Ankara, Turkey.
Clin Lab Haematol. 2006 Jun;28(3):211-4. doi: 10.1111/j.1365-2257.2006.00779.x.
The treatment of patients with non-Hodgkin's lymphoma (NHL) may be complicated by concomitant chronic hepatitis C virus (HCV) infection. Recent data suggest that HCV may also be a contributing factor to the development of this disease. Although antiviral treatment has occasionally been reported to result in the regression of lymphoma in patients with HCV infection, the importance of the control of this infection on the prognosis of lymphoma needs to be defined. Here we report a patient with diffuse large B-cell lymphoma who presented with a mass in her left breast. She had had HCV-related liver cirrhosis for 6 years. She was given rituximab monotherapy for three consecutive weeks, but treatment had to be discontinued as a result of hematological toxicity. HCV viral load also increased, but then decreased gradually after rituximab was stopped. She could be given no further therapy. Six months later she presented with spinal involvement with infiltration of the cauda equina. Though cranial-spinal radiotherapy and steroids were started, she died shortly thereafter. Though rituximab is an invaluable drug in the treatment of B-cell lymphomas, we believe that the use of such agents with potentially long-lasting effects on B lymphocytes requires extended vigilance for accelerated replication of hepatitis B and C viruses.
非霍奇金淋巴瘤（NHL）患者的治疗可能因合并慢性丙型肝炎病毒（HCV）感染而变得复杂。最近的数据表明，HCV也可能是该疾病发生的一个促成因素。尽管偶尔有报道称抗病毒治疗可使HCV感染患者的淋巴瘤消退，但控制这种感染对淋巴瘤预后的重要性仍有待明确。在此，我们报告一名患有弥漫性大B细胞淋巴瘤的患者，她的左乳出现肿块。她患有HCV相关肝硬化已6年。她连续三周接受利妥昔单抗单药治疗，但由于血液学毒性不得不停药。HCV病毒载量也升高了，但在停用利妥昔单抗后逐渐下降。她无法再接受进一步治疗。6个月后，她出现脊髓受累，马尾神经浸润。尽管开始了全脑全脊髓放疗和使用类固醇，但她此后不久便去世了。尽管利妥昔单抗在B细胞淋巴瘤的治疗中是一种非常重要的药物，但我们认为，使用这类对B淋巴细胞可能有持久影响的药物时，需要对乙型和丙型肝炎病毒的加速复制保持更长时间的警惕。
