Department of Public Medicine, Section of Infectious Diseases, Second University of Naples, Naples, Italy.
Dig Liver Dis. 2012 Jan;44(1):49-54. doi: 10.1016/j.dld.2011.07.016. Epub 2011 Aug 31.
To evaluate changes in Hepatitis C Virus (HCV) RNA both in plasma and Peripheral Blood Mononuclear Cells (PBMC) in onco-haematological patients.
8 consecutive anti-HCV/HCV RNA-positive patients with onco-haematological diseases (5 with B-cell Non-Hodgkin Lymphoma and 3 with chronic lymphocytic leukaemia) were observed during chemotherapy and after its discontinuation. All were naïve to chemotherapy. HCV RNA was sought by Real Time Polymerase Chain Reaction in Light Cycler 1.5 in plasma and PBMC samples collected before, during and after chemotherapy.
An increase in HCV RNA of at least 1.5 log IU/mL in plasma and 1.1 log IU/ml in PBMC was observed in all 7 patients undergoing Rituximab-based chemotherapy; these patients showed a hepatic flare after discontinuation, life-threatening in one with cirrhosis. Also the 8th patient had cirrhosis, but was treated with Rituximab-sparing chemotherapy and did not show any increase in HCV RNA or a hepatic flare.
Rituximab-based chemotherapy favours an increase in HCV RNA in onco-haematological patients; this is followed by a hepatic flare, possibly immune-mediated and life threatening in cirrhotic patients.
评估肿瘤血液病患者血浆和外周血单个核细胞（PBMC）中丙型肝炎病毒（HCV）RNA 的变化。
观察了 8 例连续的抗 HCV/HCV RNA 阳性的肿瘤血液病患者（5 例 B 细胞非霍奇金淋巴瘤和 3 例慢性淋巴细胞白血病），他们在化疗期间和停止化疗后均未接受过化疗。采用 LightCycler 1.5 上的实时聚合酶链反应（PCR）在血浆和 PBMC 样本中检测 HCV RNA，这些样本在化疗前、化疗期间和化疗后采集。
接受基于利妥昔单抗的化疗的 7 例患者的血浆 HCV RNA 增加至少 1.5 log IU/ml，PBMC 增加 1.1 log IU/ml；这些患者在停止化疗后出现肝发作，1 例肝硬化患者危及生命。第 8 例患者也患有肝硬化，但接受了利妥昔单抗节约化疗，HCV RNA 或肝发作没有增加。
基于利妥昔单抗的化疗有利于肿瘤血液病患者 HCV RNA 的增加；随后发生肝发作，可能是免疫介导的，在肝硬化患者中危及生命。
