BCL-2 rearrangement in mixed cryoglobulinemia and HCV-positive liver disease patients

Zignego, A.L.; Giannelli, Francesca; Giannini, Carlo; Ferri, Clodoveo; Marrocchi, M.E.; Mazzocca, Antonio; Geñtilini, Paolo

doi:10.1016/s0168-8278(98)80561-8

Cited by 14 publications

(20 citation statements)

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“…This study was justified by previous observations showing the significant association existing between Bcl-2 rearrangement (14;18 translocation) and chronic HCV infection, especially in those patients developing type II MC [93][94][95][96][97][98] , and MALT lymphoma [99] . In type II MC patients, the analysis of synchronous and metachronous blood samples showed the clonal expansion of B-cells harboring this chromosomal rearrangement [95] .…”

Section: Pathogenesis Of Hcv-related Lymphoproliferative Disordersmentioning

confidence: 62%

Hepatitis C virus-related lymphoproliferative disorders: An overview

Zignego

Giannini²,

Ferri³

2007

WJG

111

106

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Hepatitis C virus (HCV) is a global health problem affecting 3% of the world's population (about 180 million) and a cause of both hepatic and extrahepatic diseases. B-cell lymphoproliferative disorders, whose prototype is mixed cryoglobulinemia, represent the most closely related as well as the most investigated HCVrelated extrahepatic disorder. The association between extrahepatic (lymphoma) as well as hepatic malignancies (hepatocellular carcinoma) has justified the inclusion of HCV among human cancer viruses. HCV-associated manifestations also include porphyria cutanea tarda, lichen planus, nephropathies, thyreopathies, sicca syndrome, idiopathic pulmonary fibrosis, diabetes, chronic polyarthritis, sexual dysfunctions, cardiopathy/ atherosclerosis, and psychopathological disorders. A pathogenetic link between HCV virus and some lymphoproliferative disorders was confirmed by their responsiveness to antiviral therapy, which is now considered the first choice treatment. The aim of the present paper is to provide an overview of extrahepatic manifestations of HCV infection with particular attention to B-cell lymphoproliferative disorders. Available pathogenetic hypotheses and suggestions about the most appropriate, currently available, therapeutic approaches will also be discussed.

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Section: Pathogenesis Of Hcv-related Lymphoproliferative Disordersmentioning

confidence: 62%

Hepatitis C virus-related lymphoproliferative disorders: An overview

Zignego

Giannini²,

Ferri³

2007

WJG

111

106

View full text Add to dashboard Cite

show abstract

“…[6][7][8] Other reports dealt with the detection of bcl-2 rearrangement in HCV-related type II mixed cryoglobulinemia (MCII). [9][10][11] KitayCohen and coworkers detected bcl-2 rearrangement by fluorescence in situ hybridization in 13 of 15 (86%) patients with MCII.…”

Section: Introductionmentioning

confidence: 99%

Effect of antiviral treatment in patients with chronic HCV infection and t(14;18) translocation

Giannelli

Moscarella

Giannini

et al. 2003

Blood

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Hepatitis C virus (HCV) may be associated with the mixed cryoglobulinemia syndrome and other B-cell lymphoproliferative disorders (LPDs). The t(14;18) translocation may play a pathogenetic role. Limited data are available regarding the effects of antiviral therapy on rearranged B-cell clones. We evaluated the effects of interferon and ribavirin on serum, B-lymphocyte HCV RNA, and t(14; 18) in 30 HCV ؉ , t(14;18) ؉ patients without either mixed cryoglobulinemia syndrome or other LPDs. The t(14;18) translocation was analyzed by both bcl-2/J H polymerase chain reaction and bcl-2/J H junction sequencing in peripheral blood mononuclear cells in all patients. Fifteen untreated patients with comparable characteristics served as controls. Throughout the study, the presence or absence of both t(14;18) and HCV RNA sequences were, in most cases, associated in the same cell samples. At the end of treatment, t(14;18) was no longer detected in 15 patients (50%) with complete or partial virologic response, whereas it was persistently detected in nonresponders (P < .05), as well as in 14 of 15 control patients. In 4 responder patients, t(14;18) and HCV RNA sequences were no longer detected in blood cells after treatment, but were again detected after viral relapse; the same B-cell clones were involved in the pretreatment and posttreatment periods. In conclusion, this study suggests that antiviral therapy may induce regression of t(14;18)-bearing Bcell clones in HCV ؉ patients and that this phenomenon may be related, at least in part, to the antiviral effect of therapy. This in turn suggests that antiviral treatment may help prevent or treat HCV-related

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“…In particular, these infiltrates have been considered as "early lymphomas", as they include lymphoid elements indistinguishable from those of B-cel1 lymphoma/chronic leukaemia (B-CLLlBCL) and from immunocytoma (Ic) (36). However, apart from malignant, lymphomas, they usually remain unchanged for years and are followed by lymphoid malignancies only in 10% of the cases (37). These characteristics justify the term, recently suggested, of "monotypic lymphoproliferative disorder of undetermined significance (MLDUS)" (37).…”

Section: Cryoglobulinaemia Hcv and Lymphoma Genesismentioning

confidence: 99%

“…However, apart from malignant, lymphomas, they usually remain unchanged for years and are followed by lymphoid malignancies only in 10% of the cases (37). These characteristics justify the term, recently suggested, of "monotypic lymphoproliferative disorder of undetermined significance (MLDUS)" (37). Type II MC-related MLDUS has the highest incidence in the same geographic area where about 30% of patients affected by "idiopathic" BCL also show antibodies against HCY and where an increased prevalence ofHCY genotype 2a/c has been observed either in MC either in BCL (20).…”

Section: Cryoglobulinaemia Hcv and Lymphoma Genesismentioning

confidence: 99%

Cryoglobulinaemia: A True Internistic Disease?

Manna

Miele

Regina

et al. 2003

Int J Immunopathol Pharmacol

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Cryoglobulinemia is a clinical condition characterised by the presence of circulating globulins that precipitate at a temperature lower than 37°C and re-dissolve with warming. We can distinguish 3 different types of cryoglobulinemia, according to their immunochemical characteristics. Cryoglobulinemia can be associated with infectious, inflammatory or neoplastic diseases. Cryoglobulinemia type II can be associated with chronic HCV-hepatitis. Clinically, cryoglobulinemias cause hyperviscosity-related symptoms or lesions by immunocomplex deposition (cryoglobulinemic vasculitis). Many organs and systems can be involved, from the skin to the joints, from the central nervous system to the kidney. Diagnosis requires a careful clinical and physical evaluation and the demonstration of circulating cryoglobulins by cryoprecipitation and immunoelectrophoresis. The therapeutic goals are the treatment of the underlying diseases and the complication and prevention of progression/relapse. It is obvious that this disorder can involve different specialists, but the internist plays a central role: heidentifies the disease and the associated condition, he treats the underlying disorder and refers the patient to the specialists for the organ-specific manifestations.

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BCL-2 rearrangement in mixed cryoglobulinemia and HCV-positive liver disease patients

Cited by 14 publications

References 0 publications

Hepatitis C virus-related lymphoproliferative disorders: An overview

Hepatitis C virus-related lymphoproliferative disorders: An overview

Effect of antiviral treatment in patients with chronic HCV infection and t(14;18) translocation

Cryoglobulinaemia: A True Internistic Disease?

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