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

Franco Dammacco, Felicia Anna Tucci, Gianfranco Lauletta, Pietro Gatti, Valli De Re, Vincenza Conteduca, Silvia Sansonno, Sabino Russi, Maria Addolorata Mariggiò, Maria Chironna, Domenico Sansonno

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)343-353
Number of pages11
JournalBlood
Volume116
Issue number3
DOIs
Publication statusPublished - Jul 22 2010

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

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    Dammacco, F., Tucci, F. A., Lauletta, G., Gatti, P., De Re, V., Conteduca, V., Sansonno, S., Russi, S., Mariggiò, M. A., Chironna, M., & Sansonno, D. (2010). Pegylated interferon-α, ribavirin, and rituximab combined therapy of hepatitis C virus-related mixed cryoglobulinemia: A long-term study. Blood, 116(3), 343-353. https://doi.org/10.1182/blood-2009-10-245878