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Annals of Oncology Advance Access originally published online on March 8, 2006
Annals of Oncology 2006 17(5):769-772; doi:10.1093/annonc/mdl027
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© 2006 European Society for Medical Oncology

Clinical implications of hepatitis C virus infection in MALT-type lymphoma of the ocular adnexa

A. J. M. Ferreri1,*, E. Viale2, M. Guidoboni3, A. Giordano Resti4, C. De Conciliis5, L. Politi6, A. A. Lettini3, F. Sacchetti3, R. Dolcetti3, C. Doglioni7 and M. Ponzoni7

1 Medical Oncology, 2 Gastroenterology, 4 Ophthalmology, 6 Neuroradiology, and 7 Pathology Units, San Raffaele H Scientific Institute, Milan, Italy; 3 Immunovirology and Biotherapy Unit, Department of Pre-Clinical and Epidemiological Research, Centro di Riferimento Oncologico, IRCCS National Cancer Institute, Aviano, Italy; 5 Ophthalmology Unit, Ospedale San Giuseppe, Milan, Italy

* Correspondence to: Dr A. J. M. Ferreri, Medical Oncology Unit, Dept. of Oncology, San Raffaele H Scientific Institute, Via Olgettina 60, 20132 Milan, Italy. Tel: +39-02-26437649; Fax: +39-02-26437603; E-mail: andres.ferreri{at}hsr.it

Background: A pathogenic link between hepatitis C virus (HCV) and MALT-type lymphomas has been suggested. However, studies assessing the role of HCV infection separately in different forms of MALT lymphomas are not available.

Patients and methods: The prevalence and clinical implications of HCV seropositivity were analyzed in 55 patients with ocular adnexa lymphoma (OAL) of MALT-type.

Results: HCV seropositivity was detected in seven (13%) patients. At presentation, HCV infection was significantly associated with concomitant extra-orbital disease, lymph node dissemination and involvement of additional extranodal organs. HCV seropositivity was associated also with a higher relapse rate and worse progression-free survival. In fact, 16 patients experienced relapse after first-line treatment: five (71%) were HCV-seropositive and 11 (23%) were HCV-seronegative, with a median TTP of 31 and 50+ months (P = 0.01), and a 5-year progression-free survival of 43 ± 18% and 77 ± 7% (P = 0.005), respectively. HCV-seropositive patients experienced frequent relapses despite further lines of therapy; relapses were systemic in all cases but one; multiple subcutaneous nodules were common at relapse.

Conclusions: HCV seropositivity is present in 13% of OAL of MALT-type. Concomitant HCV infection is associated with more disseminated disease and aggressive behavior in OAL, with a consequent potential negative impact in patients managed with radiotherapy alone.

Key words: MALT lymphoma, ocular adnexal lymphoma, hepatitis C virus, infectious agents


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