Related Experiment Videos
[Peripheral spontaneous remission of hairy cell leukemia following transfusion-associated hepatitis C]
R Morant1, B Thürlimann, W F Jungi
1Abteilung für Onkologie/Hämatologie, Medizin C, Hoffmann-La Roche, Basel.
Insights
A patient with hairy cell leukemia experienced a spontaneous, long-lasting hematologic remission, potentially linked to chronic hepatitis C infection and endogenous interferon production.
Area of Science:
- Hematology
- Hepatology
- Immunology
Background:
- Hairy cell leukemia (HCL) is a rare B-cell malignancy.
- Treatment resistance is common in advanced HCL.
- Transfusion-associated complications, like hepatitis C, can occur.
Observation:
- A patient with refractory HCL developed chronic hepatitis C post-transfusion.
- The patient achieved a sustained hematologic remission of HCL.
- Bone marrow leukemic infiltrates persisted despite hematologic remission.
Findings:
- Spontaneous, long-term hematologic remission in HCL.
- Chronic hepatitis C infection potentially induced remission.
- Endogenous interferon production suggested as the mechanism.
- Low serum interferon-alpha and -gamma levels detected.
Implications:
- Chronic hepatitis C may have a beneficial effect on HCL.
- Endogenous interferon could be a therapeutic target for HCL.
- Further research into the HCL-hepatitis C interaction is warranted.
Abstract:
In a 59-year-old patient presenting in October 1981 with pancytopenia, hairy cell leukemia was diagnosed. Splenectomy, followed by treatments with oncovin, lithium, and prednisone were essentially without effect. Up to July 1984 the patient had been regularly transfused with a total of 62 unit. In June 1984 he acquired a transfusion associated hepatitis C which followed a chronic course and resulted in biopsy proven cirrhosis in 1989. The patient became independent of transfusions in July 1984. Repeated blood counts have shown a complete hematologic remission which has now lasted nearly 6 years, whereas focal leukemic infiltrates have persisted in the bone marrow. The patient has tolerated 20 courses of erythropheresis performed because of biopsy proven severe hepatic siderosis without a fall in hemoglobin. It is suggested that the spontaneous long-lasting hematologic remission of hairy cell leukemia is due to endogenous interferon produced in the course of chronic hepatitis C. Low serum levels of interferon-alpha and -gamma were detected.