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How I treat hepatitis C virus infection in patients with hematologic malignancies

Harrys A. Torres and George B. McDonald

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  • Very rapid response of an HCV-related lymphoplasmacytic lymphoma (LPL) to an NS3/4A agentRE:
    • Georgios Germanidis, Hepatology Consultant First Department of Internal Medicine, AHEPA Hospital of the Aristotle University Medical School, Greece
    • Other Contributors:
      • Mary Papaioannou, Hematology Consultant
      • Simeon Metallidis, Infectious Diseases Consultant
      • Olga Tsachouridou, Internist
      • Georgia Loli, Internist
      • Ioannis Kostopoulos, Pathology Consultant
      • kostas stamatopoulos, Hematology, Molecular Immunology Consultant
      • Pantelis Zebekakis, Director

    Very rapid response of an HCV-related lymphoplasmacytic lymphoma (LPL) to an NS3/4A agent

     

    Georgios Germanidis*, Mary Papaioannou , Simeon Metallidis , Olga Tsachouridou ,

    Georgia Loli , Ioannis Kostopoulos , Kostas Stamatopoulos , and Pantelis Zebekakis.

     

     

    To comment on a recent Blood article(1), we report a 76-year-old woman  diagnosed with HCV cirrhosis in  4/2015 with ascites, F2 esophageal varices without red spots, Hb 10.2g/dL, PLTs60-80,000/mm3, compatible triple phase hepatic CT without nodules and Child-Pugh score B7. HCV genotype was 1b and viral load 597,000IU/mL. A monoclonal IgMk was found and immune-phenotype revealed a CD19+ve, CD20+ve, CD23-ve, CD5-ve monoclonal population(4,474/mm3), forming 49.6% of PBMCs, compatible with an HCV-associated low-grade LPL(2).A new hospitalization in 7/2015 was urged by a threatening  diffuse hemorrhagic gastropathy with PLTs<5,000/mm3, and the patient was transfused with 4RBCs, 6FFPs and twice with 12PLT units. A bone marrow(BM) biopsy showed an HCV-associated low grade LPL occupying approximately the 40% of BM space(Fig.1A).A new immune-phenotype showed the CD19+ve monoclonal B cell population increasing to 84% of PBMCs. Analysis of genes of the variable region of the IGs heavy chain showed the gene rearrangement IGHV4-39/IGHD5-12/IGHJ5 with...

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    Conflict of Interest:
    None declared.