Background/Purpose: patients with cryoglobulinemic vasculitis (CV) or serum cryoglobulins without CV (CwV) a have an increased risk of lymphoma development. We compared the prevalence of lymphoma in HCV-positive or -negative patients with cryoglobulinemia.Methods: fifty hundred patients with positive serum cryoglobulins were studied. Mean age was 60.77±13.75 years, they were 356 females (71.2%) and 144 males (28.8%), and the first cryoglobulin positivity occurred thirty-four months before the last evaluation (range 3-290 months). 272 patients had CV (54.4%). The other 228 patients (45.6%) had other diseases associated with CwV. One hundred and seventeen HCV negative patients were collected and they were 42/272 (15.4%) among CV, while they were 75/228 (32.9%) among CwV. Results: globally, a lymphoma was diagnosed in thirty-two patients (32/500, 6.4%). Of them, fourteen patients were HCV negative (14/32, 43.7%). Furthermore, lymphoma was diagnosed in 18/383 HCV positive patients (4.7%), and 14/117 HCV negative patients (11.9%) (p=0.005, Pearson). Among the 18 HCV positive patients with lymphoma, a CV was present in 16/18 (88.9%), while among the 14 HCV negative patients with lymphoma, a CV was present in 10/14 (71.4%). In HCV positive, as well as in HCV negative patients, the diagnosis of a CV increases the risk of almost 5-6 times the risk of lymphoma (p=0.022, OR 5.7, 95% CI 1.3-25.1, and p=0.006, OR 5.5, 95% CI 1.6-19.0 for HCV positive and HCV negative patients, respectively). Among HCV negative patients, a Sjögren's syndrome (SS) was diagnosed in 55/117 (47%).Conclusion: CV, much more than CwV, is associated with lymphoma prevalence. Lymphoma prevalence is higher in CV without HCV infection than in CV associated with HCV infection. Thus, lymphoma should be suspected with much higher attention in HCV negative CV patients, who often suffered from SS.
Lymphoma Prevalence in Patients with Serum Cryoglobulins with or without Cryoglobulinemic Vasculitis: Data Extrapolated From the Cryoglobulinemic Vasculitis Classification Criteria Database / Quartuccio, L.; Corazza, L.; Monti, G.; Gabrielli, A.; Tzioufas, Ag; Ferri, Clodoveo; Ferraccioli, G.; Ramos Casals, M.; Voulgarelis, M.; Lenzi, M.; Mascia, Maria Teresa; Sansonno, D.; Cacoub, P.; Tomsic, M.; Tavoni, A.; Pietrogrande, M.; Zignego, Al; Scarpato, S.; Pioltelli, P.; Steinfeld, Sd; Lamprecht, P.; Bombardieri, S.; Galli, M.; De Vita, S.. - In: ARTHRITIS AND RHEUMATISM. - ISSN 0004-3591. - STAMPA. - 63:10(2011), pp. 597-597. (Intervento presentato al convegno ACR tenutosi a Chicago nel 5-9/11).
Lymphoma Prevalence in Patients with Serum Cryoglobulins with or without Cryoglobulinemic Vasculitis: Data Extrapolated From the Cryoglobulinemic Vasculitis Classification Criteria Database.
FERRI, Clodoveo;MASCIA, Maria Teresa;
2011
Abstract
Background/Purpose: patients with cryoglobulinemic vasculitis (CV) or serum cryoglobulins without CV (CwV) a have an increased risk of lymphoma development. We compared the prevalence of lymphoma in HCV-positive or -negative patients with cryoglobulinemia.Methods: fifty hundred patients with positive serum cryoglobulins were studied. Mean age was 60.77±13.75 years, they were 356 females (71.2%) and 144 males (28.8%), and the first cryoglobulin positivity occurred thirty-four months before the last evaluation (range 3-290 months). 272 patients had CV (54.4%). The other 228 patients (45.6%) had other diseases associated with CwV. One hundred and seventeen HCV negative patients were collected and they were 42/272 (15.4%) among CV, while they were 75/228 (32.9%) among CwV. Results: globally, a lymphoma was diagnosed in thirty-two patients (32/500, 6.4%). Of them, fourteen patients were HCV negative (14/32, 43.7%). Furthermore, lymphoma was diagnosed in 18/383 HCV positive patients (4.7%), and 14/117 HCV negative patients (11.9%) (p=0.005, Pearson). Among the 18 HCV positive patients with lymphoma, a CV was present in 16/18 (88.9%), while among the 14 HCV negative patients with lymphoma, a CV was present in 10/14 (71.4%). In HCV positive, as well as in HCV negative patients, the diagnosis of a CV increases the risk of almost 5-6 times the risk of lymphoma (p=0.022, OR 5.7, 95% CI 1.3-25.1, and p=0.006, OR 5.5, 95% CI 1.6-19.0 for HCV positive and HCV negative patients, respectively). Among HCV negative patients, a Sjögren's syndrome (SS) was diagnosed in 55/117 (47%).Conclusion: CV, much more than CwV, is associated with lymphoma prevalence. Lymphoma prevalence is higher in CV without HCV infection than in CV associated with HCV infection. Thus, lymphoma should be suspected with much higher attention in HCV negative CV patients, who often suffered from SS.
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