LOW-GRADE MALIGNANT-LYMPHOMA, HEPATITIS-C VIRUS-INFECTION, AND MIXED CRYOGLOBULINEMIA

Because a close relationship has been established between mixed cryogl obulinemia and hepatitis C virus (HCV) infection, the clinical, histol ogic, and virologic findings of 31 patients affected by mixed cryoglob ulinemia have been determined. HCV infection was investigated by the p resence of anti-HCV antibodies and by polymerase chain reaction (PCR) amplification of the 5' untranslated region (5'UTR), and the genotype of HCV was also determined according to Okamoto et al (J Gen Virol 73: 673, 1992). A bone marrow (BM) biopsy was performed in all patients, a nd liver and kidney biopsies were performed when indicated. The preval ence of anti-HCV antibodies was high (83.9%); polymerase chain reation amplification of the 5' untranslated region was positive in 26 subjec ts (83.9%), and Core region amplification in 26 of 27 subjects (96.2%) . A high prevalence of genotype II was found (76.6%). Chronic liver di sease was present in 15 (48%) patients, BM biopsy specimens showed the presence of low-grade non-Hodgkin's lymphomas in 12 cases (38.7%), wh ereas, in 11 patients (35.5%), the BM infiltration was not monoclonal (reactive). Mixed cryoglobulinemia is closely associated with HCV infe ction. Apparently, only 1 patient was not infected by the virus. Sever al HCV genotypes are involved in the pathogenesis of mixed cryoglobuli nemia. The disease is associated with a high prevalence of low-grade n on-Hodgkin's lymphomas. (C) 1994 by The American Society of Hematology .