By Edward Edelson HealthDay Reporter

Updated on June 15, 2022

WEDNESDAY, July 10, 2002 (HealthDayNews) -- Treating a viral infection can help some patients with a rare cancer of the immune system, French researchers say in a finding that might sound esoteric but offers a new way to fight many kinds of leukemia and lymphoma.

The cancer is splenetic lymphoma, a malignant overgrowth of the white cells the body makes as a reaction to infection, and the infectious agent is hepatitis C virus. Seven of nine patients with the lymphoma had complete remissions after they were given interferon to fight the virus. Two other patients had the same remission when ribavirin, another antiviral drug, was added to the treatment, says a report from researchers at Necker Hospital in Paris. It appears in tomorrow?s New England Journal of Medicine.

All those patients were given the antiviral drugs because they tested positive for hepatitis C. Tellingly, six patients with the same lymphoma who were not infected with hepatitis C were not helped by antiviral treatment.

Why is such a small trial interesting? Because it adds to the growing body of evidence that an infection can trigger a cancer of the immune system, says Alan J. Kinniburgh, vice president for research of the Leukemia and Lymphoma Society.

"A virus elicits a response of the immune system to fight the infection, and in that process there is rapid division of white cells," Kinniburgh explains. "There may be mistakes made in replicating those cells, and some of the resulting cells have a growth advantage that continues and manifests itself as these rare lymphomas. What this study points to is that these infectious agents may be participating in other lymphoid diseases, such as chronic lymphoid leukemia."

Both lymphomas and leukemias are malignant overgrowths of white blood cells, Kinniburgh says. "If the disease occurs in the blood and not in the lymph nodes, we call it a leukemia," he says. "If it occurs in the lymph nodes, we call it a lymphoma. This one occurs in the spleen, as well as the lymph nodes."

One prospect is to detect such a cancer in its early stages, he says: "If we can recognize that this process is occurring, we could use antiviral treatment to stop it. But that now is speculation. We need much more research in this area."

A role for viruses in leukemias and lymphomas was recognized as early as the 1960s, when the Epstein-Barr virus was detected in a malignancy called Burkitt's lymphoma, says an accompanying commentary by Dr. Joseph S. Pagano of the University of North Carolina at Chapel Hill. Since then, more than half a dozen viruses have been associated with different lymphomas, Pagano says, and the new report "broadens our perspective."

However, the picture is complex, Pagano and Kinniburgh say. Many people are infected with the hepatitis C virus, and very few of them develop lymphoma, and not everyone with a lymphoma is infected with the virus, Kinniburgh says. In the French report, six of 15 patients did not have the infection.

However, looking for signs of infection in patients with leukemia and lymphoma could lead to new treatments, Pagano writes.

"A holy grail in cancer is the discovery of cellular markers that are distinct from those found in normal cells," he says. "Thus, virus-associated cancers that express viral neoantigens serve as inviting targets for specific therapeutic interventions."

"Larger therapeutic trials of antiviral therapy are needed to determine the role of antiviral therapy in hepatitis C virus-infected patients with low-grade lymphoma," the French researchers write.

What To Do

You can learn more about these cancers from the National Library of Medicine or the Leukemia and Lymphoma Society. The Centers for Disease Control and Prevention has a page on hepatitis C.

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