Annals of Oncology Advance Access originally published online on October 25, 2006
Annals of Oncology 2007 18(2):400-401; doi:10.1093/annonc/mdl369
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© 2007 European Society for Medical Oncology
letters to the editor |
Hepatitis C virus infection and MALT-type ocular adnexal lymphoma
The association of hepatitis C virus (HCV) and non-Hodgkin's lymphoma has been repeatedly reported, especially for splenic lymphoma with villous lymphocytes and mucosa-associated lymphoid tissue (MALT)-type lymphoma [1]. Recently, Ferreri et al. [2] reported a clinical implication of HCV in MALT-type lymphoma of the ocular adnexa (OAL). We therefore investigated this association in our large series of patients with MALT-type lymphoma having one or more ophthalmologic sites at diagnosis, together with the prevalence of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) seropositivity.In the population of patients with primary MALT-type OAL treated at the Institut Curie, 54 had determination of their serological status assessed by an enzyme-linked immunosorbent assay (ELISA) test (BioRad, 34; then Ortho, 64) for HCV, an enzyme-linked fluorescent assay test (VIDAS Biomerieux, 92) and then an ELISA test (Dade Behring, 6) for HBV, and various types of ELISA tests for HIV [genscreen BioRad and HIV enzygnost Intégral I (Dade Behring), 61; and HIV Duo (VIDAS Biomerieux) and HIV enzygnost Intégral I (Dade Behring), 37]. The characteristics of these patients were as follows: median age 65 years (range: 31–93 years) and male/female sex ratio 0.8. Ophthalmologic sites were intraorbital in 21 cases (39%), conjunctival in 25 cases (46%), palpebral in three cases, lacrimal in five cases, and bilateral in seven cases (13%), with nodal involvement in eight cases (16%) and nonophthalmologic visceral involvement in 11 cases (20%), while five patients presented lymphomatous bone marrow involvement (9%). With a median follow-up of 23 months (range: 1–80 months), four patients relapsed at 13, 13, 18, and 22 months and two patients died in whom one was of lymphomatous evolution.
HCV antibodies were detected in only one patient with MALT-type lymphoma (2%) presenting disseminated conjunctival, pelvic, and bone marrow lesions at diagnosis with a fatal outcome in 29 months. HCV RNA levels were not determined in this patient. HBV antibodies were detected in 10 patients, six of whom presented antibody to surface antigen of HBV and antibody to core antigen of HBV (HBcAg), while one only had antibody to HBcAg. HIV antibodies were not detected in any patients of our series.
In conclusion, we did not find an association between HCV infection and MALT-type OAL or between HBV and HIV infections and MALT-type OAL. This negative result is not concordant with what was reported by Ferreri et al. [2], who showed HCV seropositivity in 13% of patients in their series. This discrepancy could be partly explained by a lower incidence of HCV infection in France than in Italy, geographical variations of HCV prevalence [3, 4], and differences between the Italian series and our OAL series. Moreover, although our HCV-positive patient had a poor outcome, as reported by Ferreri et al., we did not confirm any association between disseminated MALT-type OAL and HCV infection. The level of association between HCV infection and B-cell lymphomas is still debated, especially for MALT-type lymphoma for which HCV infection was [5] or was not [6] observed. In this report, we did not confirm the association between HCV infection and OAL of MALT type. This observation, combined with the fact that no efficacy of antiviral therapy has yet been reported in HCV-positive MALT-type OAL, indicates that HCV infection is not a critical event in the development of primary ophthalmologic MALT-type lymphoma.
1 Department of Clinical Hematology
2 Department of Tumor Biology, Institut Curie, Paris
3 Department of Infectious Diseases, Necker-Enfants malades Hospital/Avenir Group Inserm, Institut Pasteur, Paris
4 Department of Ophthalmology
5 Department of Statistics, Institut Curie, Paris
6 Department of Pathology, Necker-Enfants malades Hospital, Paris
7 Department of Clinical Hematology, Necker-Enfants malades Hospital/CNRS UMR 8603, IFR94, René Descartes—Paris 5 University Medical School, Paris
8 UMR 144 CNRS, Institut Curie, Paris, France
* E-mail: didier.decaudin{at}curie.net
References
1. Suarez F, Lortholary O, Hermine O, Lecuit M. (2006) Infection-associated lymphomas derived from marginal-zone B-cells: a model of antigen-driven lymphoproliferation. Blood 107:3034–3044.
2. Ferreri AJM, Viale E, Guidoboni M, et al. (2006) Clinical implications of hepatitis C virus infection in MALT-type lymphoma of the ocular adnexa. Ann Oncol 17:769–772.
3. Hausfater P, Cacoub P, Sterkers Y, et al. (2001) Hepatitis C virus infection and lymphoproliferative diseases: prospective study on 1,576 patients in France. Am J Hematol 67:168–171.[CrossRef][Web of Science][Medline]
4. Mele A, Pulsoni A, Bianco E, et al. (2003) Hepatitis C virus and B-cell non-Hodgkin lymphomas: an Italian multicenter case–control study. Blood 102:996–999.
5. Ambrosetti A, Zanotti R, Pattaro C, et al. (2004) Most cases of primary salivary mucosa-associated lymphoid tissue lymphoma are associated either with Sjögren syndrome or hepatitis C virus infection. Br J Haematol 126:43–49.[CrossRef][Web of Science][Medline]
6. Tkoub EM, Haioun C, Pawlotsky JM, et al. (1998) Chronic hepatitis C virus and gastric MALT lymphoma. Blood 91:360–369.[Web of Science][Medline]
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