This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Vallisa, D. Articles by Cavanna, L. Search for Related Content PubMed Articles by Vallisa, D. Articles by Cavanna, L. Related Articles Related Correspondence

In Reply:

Department of Oncology and Hematology, G. da Saliceto Hospital, Piacenza, Italy

The experience of Mazzaro et al¹ with antiviral therapy in hepatitis C virus (HCV) -related lymphomas was undoubtedly very useful in the design of our protocol.² However, whereas these authors mainly treated immunocytoma (plasmocytoid lymphoma), the aim of our study was to extend antiviral treatment among all HCV-related low-grade B-cell lymphomas. As we have previously observed,³ HCV-related lymphoma does not strictly correlate with cryoglobulinemia, because its incidence varies according to different subtypes of lymphoma, and it is more likely to be found among immunocytomas.

In our series,² of 13 patients with HCV-related low-grade B-cell lymphomas, cryoglobulinemia was detected in only five patients (Table 1). All five patients expressed type II mixed cryoglobulinemia (that is, polyclonal immunoglobulin [Ig] G complexed with monoclonal IgM). Moreover, among our 13 patients, four patients presented with plasmocytoid lymphoma, three of whom were affected by cryoglobulinemia. So, cryoglobulimenia was more likely to be found among patients with plasmocytoid lymphoma (three of four patients v two of nine patients), while its presence did not predict good or poor response to antiviral treatment. HCV genotype 1b was predominant in cryoglobulinemic patients (three of four assessable patients, because one genotype was not available; Table1). At diagnosis, arthralgias, myalgias, and purpura were present in three patients, whereas arthralgias alone were present in two patients. Cryoglobulinemia response to pegylated interferon alfa-2b and ribavirin appeared to be related (albeit not strictly) to hematologic response (two of three patients v zero of one patient; one patient was not available for toxicity), although the small number of patients did not allow any statistical evaluations.

The authors indicated no potential conflicts of interest.

REFERENCES

1. Mazzaro C, Franzin F, Tulissi P, et al: Regression of monoclonal B-cell expansion in patients affected by mixed cryoglobulinemia responsive to -interferon therapy. Cancer 77:2604-2613, 1996[CrossRef][Medline]

2. Vallisa D, Bernuzzi P, Arcaini L, et al: Role of anti-hepatitis C virus (HCV) treatment in HCV-related, low grade, B-cell, non-Hodgkin's lymphoma: A multicenter Italian experience. J Clin Oncol 23:468-473, 2005[Abstract/Free Full Text]

3. Luppi M, Ferrari MG, Bonaccorsi G, et al: Hepatitis C virus infection in subsets of neoplastic lymphoproliferations not associated with cryoglobulinemia. Leukemia 10:351-355, 1996[Medline]

Related Correspondence

• Regression of Low-Grade Non-Hodgkin's Lymphoma After Treatment With Pegylated Interferon Plus Ribavirin in Hepatitis C Virus Infection
  Cesare Mazzaro, Michele Spina, and Umberto Tirelli
  JCO 2005 23: 4470-4471 [Full Text]

This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Vallisa, D. Articles by Cavanna, L. Search for Related Content PubMed Articles by Vallisa, D. Articles by Cavanna, L. Related Articles Related Correspondence