Case Report

Waldenström Macroglobulinemia in Hepatitis C: Case Report and Review of the Current Literature

Table 1

Publications reviewed. Second column includes whether the authors concluded that there is an association between hepatitis C virus infection and Waldenström macroglobulinemia in their cohort and a brief summary of relevant findings. Third column summarizes the treatment strategy for patients with comorbid hepatitis C virus infection and Waldenström macroglobulinemia.

ArticleDid authors conclude an association between HCV and WM?Treatment given for HCV and WM, and patient outcomes

Santini et al. 1993 [6]Yes. 6/6 WM patients were HCV positive by viral PCR.n/a

Mussini et al. 1995 [21]Yes, in setting of cryoglobulinemia. Of WM cases with cryoglobulins, 2/3 were positive for HCV RNA. 0/12 WM cases without cryoglobulins were positive for HCV.n/a

Andreone et al. 1995 [22]No. Hypothesize that association between HCV and NHL may be due by confounding factor of transfusions.n/a

Custodi et al. 1995 [13]No. 0/6 HCV positive in 6 cases of familial occurrence of IgM-k gammopathy.n/a

Izumi et al. 1996 [23]Unlikely. 1/4 patients with WM were HCV positive.n/a

Izumi et al. 1996 [20]Case report: 55-year-old man with HCV, WM, and hepatocellular carcinoma.Melphalan and prednisolone + vincristine. Death from liver failure 5 years after diagnosis.

Silvestri et al. 1996 [24]Yes, in setting of cryoglobulinemia. 1/20 WM patients with cryoglobulinemia were HCV positive. 0/19 WM patients without cryoglobulinemia were HCV positive.n/a

Silvestri et al. 1996 [25]Yes. 30% of patients with immunocytoma were HCV positive.n/a

Silvestri et al. 1997 [10]Yes. Of the HCV-positive, cryoglobulin-producing NHL cases, immunocytoma was most frequent (16/21).n/a

Izumi et al. 1997 [9]Yes. 1/4 patients with WM were HCV positive.n/a

Silvestri and Baccarani 1997 [15]Yes. 26–49% of lymphoplasmacytoid lymphomas were HCV positive.n/a

Zignego et al. 1997 [26]Yes. Mechanism of HCV infection leading to B-cell NHL may be through vasculitis and triggering of lymphoproliferative disorder.n/a

Silvestri et al. 1998 [27]Yes. 18/70 WM cases were HCV positive. 10 WM patients treated with IFN alpha for 6 to 12 months. Four patients were resistant and received fludarabine without response.

Trotter 1999 [19]Case report: 45-year-old man with cirrhosis and HCV-induced cirrhosis and WM.Recurrent plasmapheresis resolved symptoms.

Ahmed et al. 1999 [28]Yes. 3/3 patients with WM tested for HCV were positive.n/a

Vallisa et al. 1999 [4]Yes. Prevalence of HCV infection among patients with NHL was 37.1%.n/a

Silvestri et al. 2000 [5]Yes. 26% to 49% of cases of WM were HCV positive.n/a

Dammacco et al. 2000 [29]Yes. HCV reported to be lymphotropic and may trigger clonal B-cell proliferation, leading to the progression to lymphoid malignancy.n/a

Rabkin et al. 2002 [12]No. 4/95 lymphoma pts had HCV EIAs but none confirmed by recombinant immunoblot assay.n/a

Musto 2002 [30]Yes. HCV reported to be lymphotropic and may also trigger clonal B-cell proliferation, leading to malignancy.n/a

Álvarez-Ruiz et al. 2004 [17]Case report: 50-year-old man with HCV and mixed cryoglobulinemia associated with WM.IFN alpha and ribavirin for 9 months. HCV became undetectable and BM biopsy showed no lymphoid infiltration. Liver transplant performed.

Veneri et al. 2004 [11]No. HCV prevalence in WM patients similar to normal population.n/a

Neri et al. 2005 [18]Case report: 63-year-old woman with WM and type I cryoglobulinemia.Pef IFN alpha-2b treatment for 6 months. Symptoms returned after IFN treatment. Resolution of presenting skin symptoms after cyclophosphamide and prednisone addition.

Leleu et al. 2007 [2]No. 0 out of 100 WM patients studied was HCV positive.n/a

Giordano et al. 2007 [7]Yes. HCV infection with increased risk of WM, HR of 2.76 (95% CI, 2.01–3.79).n/a

Schöllkopf et al. 2008 [8]Yes. OR 5.2 (1.0–26.4) of HCV positivity in WM.n/a

Nicolosi Guidicelli et al. 2012 [3]No. Only geographic differences in prevalence of HCV in NHL.n/a

Arcaini et al. 2012 [16]Yes. Lymphoma regression following IFN-based treatment.Interferon +/− ribavirin effective in HCV + patients with indolent lymphoma.