Pegylated interferon-α, ribavirin, and rituximab combined therapy of hepatitis C virus–related mixed cryoglobulinemia: a long-term study

  • Franco Dammacco
    Sections of Internal Medicine and Clinical Oncology,
  • Felicia Anna Tucci
    Sections of Internal Medicine and Clinical Oncology,
  • Gianfranco Lauletta
    Sections of Internal Medicine and Clinical Oncology,
  • Pietro Gatti
    Sections of Internal Medicine and Clinical Oncology,
  • Valli De Re
    Clinical and Experimental Pharmacology, Department of Molecular Oncology and Translational Research, Centro di Riferimento Oncologico Aviano, Pordenone, Italy
  • Vincenza Conteduca
    Sections of Internal Medicine and Clinical Oncology,
  • Silvia Sansonno
    Clinical and Experimental Pharmacology, Department of Molecular Oncology and Translational Research, Centro di Riferimento Oncologico Aviano, Pordenone, Italy
  • Sabino Russi
    Sections of Internal Medicine and Clinical Oncology,
  • Maria Addolorata Mariggiò
    General Pathology and Experimental Oncology, and
  • Maria Chironna
    Hygiene, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari; and
  • Domenico Sansonno
    Sections of Internal Medicine and Clinical Oncology,

書誌事項

公開日
2010-07-22
DOI
  • 10.1182/blood-2009-10-245878
公開者
American Society of Hematology

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説明

<jats:title>Abstract</jats:title><jats:p>This study illustrates the use and efficacy of a combination of pegylated interferon-α (Peg-IFN-α) and ribavirin (RBV), with or without rituximab (RTX), in hepatitis C virus (HCV)–related mixed cryoglobulinemia (MC). Twenty-two patients with HCV-related MC received Peg-IFN-α (2a: 180 μg or 2b: 1.5 μg/kg) weekly plus RBV (1000 or 1200 mg) daily for 48 weeks, and RTX (375 mg/m2) once a week for 1 month followed by two 5-monthly infusions (termed PIRR). Fifteen additional patients received Peg-IFN-α/RBV with the same modalities as the PIRR schedule. Complete response was achieved in 54.5% (12/22) and in 33.3% (5/15) of patients who received PIRR and Peg-IFN-α/RBV, respectively (P < .05). Clearance of HCV RNA and conversion of B-cell populations from oligoclonal to polyclonal in liver, bone marrow, and peripheral blood was maintained for up to 3 years in 10 of 12 (83.3%) and in 2 of 5 (40%) patients receiving PIRR and Peg-IFN-α/RBV, respectively (P < .01). Cryoproteins in 22.7% (5/22) of patients with PIRR and in 33.3% (5/15) with Peg-IFN-α/RBV persisted despite sustained HCV RNA clearance. No response occurred in remaining 5 patients of both groups. PIRR therapy is well tolerated and more effective than Peg-IFN-α/RBV combination in HCV-related MC. Its effect may last for more than 3 years.</jats:p>

収録刊行物

  • Blood

    Blood 116 (3), 343-353, 2010-07-22

    American Society of Hematology

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