High prevalence of antibodies to hepatitis C virus in patients with lymphoproliferative disorders.

data about hepatitis C virus (HCV) infection in patients with hematologic malignancies are fragmentary and poor, 1-4 and concern patients who were previously treated (chemotherapy and/or transfusion) for their disease. Angelucci recently confirmed in this journal 5 that HCV infection is one of the major clinical problems of patients with thalassemia who began transfu-sional therapy before HCV screening tests became available. To our knowledge, the prevalence of HCV antibodies performed at the onset of disease in patients with hematologic malignan-cies has never been reported in the literature. Zignego et al. 6 and Bartolomé et al. 7 demonstrated that HCV is able to infect mononuclear blood cells; in addition, a role for HCV infection in the pathogenesis of Waldenström's ma-croglobulinemia and type II cryoglobulinemia has been suggested by Santini et al. 8 and by Agnello et al. 9 Recently, Ferri et al. 10 reported a high prevalence of HCV infection in a series of 50 patients with non-Hodgkin's lymphoma (NHL). These data prompted us to investigate retrospectively the prevalence of HCV antibodies among the 300 patients with lymphoproliferati-ve disorders who were admitted to our Hema-tology Department between 1985 and 1990. The population studied included 170 patients with malignant lymphomas (150 NHL and 20 Hodgkin's disease [HD]), 90 with plasma cell dyscrasias (PCD), 40 with chronic lymphocytic leukemia CLL). At admission only two patients presented a previous history of blood product transfusions or jaundice. Liver function tests were investigated in all these patients at diagnosis. All sera (collected at diagnosis, frozen and stored at –40°C) were tested for anti-HCV anti-bodies using a commercial enzyme linked im-munosorbent assay (Ortho HCV Elisa test System , second genaration, Raritan, NJ). The methods and evaluation of results were performed according to the manufacturer's instructions. In order to define the specificity of the results obtained by Elisa, reactive sera were also investigated by a second-generation (four-antigen) re-combinant immunobinding assay (RIBA 2, Chiron Corp., Emeryville, CA) and Ortho Diagnostic System. Sera were classified as positive, negative and indeterminate on the RIBA assay according to manufacturer's criteria. The prevalence of anti-HCV in the 300 patients with lym-phoproliferative disorders was compared with a control group of 3,108 blood donors (matched for age and sex), coming to our hospital's Transfusion Center. For statistical analysis we used Fisher's exact test and the chi-square test. The prevalence of HCV antibodies in the 300 patients with lymphoproliferative disorders are summarized in Table 1. At …