Reply
Journal
Hepatology
Journal Volume
64
Journal Issue
5
Date Issued
2016
Author(s)
Abstract
We appreciate the comments of Antonio et al. about our recently published paper.1 Regarding the relatively lower incidence rate (48.4/10,000 person-years) of lymphoid neoplasm from patients with hepatitis C virus (HCV) in our cohort from Taiwan, the authors provide constructive opinions on other high-risk groups of patients for lymphoma development, including patients with cirrhosis and mixed cryoglobulinemia, patients with pathogenic Helicobacter strains, and individuals carrying the hemochromatosis gene mutations or hemoglobinopathies with elevated total body iron deposits. These high-risk groups of patients should receive closer monitoring for the possible development of lymphoid neoplasms. In a recent population-based cross-sectional study using the Taiwan Cancer Registry,2 the incidence rate of lymphoid neoplasms in Taiwan was found to be significantly lower than that in the United States according to the Surveillance, Epidemiology, and End Results (SEER) database (standardized incidence rate ratio [SRR], 0.46; 95% confidence interval [CI], 0.45-0.48). The overall incidence was also lower for non-Hodgkin lymphoma (SRR, 0.56; 95% CI, 0.54-0.57), particularly B cell non-Hodgkin lymphoma (SRR, 0.52; 95% CI, 0.51-0.54). These results suggest that common ethnic differences in genetic background might play an important role in B cell transformation into lymphoid neoplasms.2 The risk factors for lymphoma development are heterogeneous. We concur with the comments from Antonio et al. that at-risk groups must be identified and that these patients need to be followed up closely for lymphoid neoplasms. Among the known risk factors, HCV is a well-documented one. In the era of direct antiviral agents against HCV infection,3 whether population-based eradication of HCV will lead to a significantly lower incidence of lymphoid neoplasms awaits further examination. Tung-Hung Su, M.D., Ph.D.1,2,3 Chi-Ling Chen, Ph.D.3 Jia-Horng Kao, M.D., Ph.D., F.A.A.S.L.D.1,2,3,4 1Division of Gastroenterology and Hepatology Department of Internal Medicine National Taiwan University Hospital Taipei, Taiwan 2Hepatitis Research Center National Taiwan University Hospital Taipei, Taiwan 3Graduate Institute of Clinical Medicine National Taiwan University College of Medicine Taipei, Taiwan 4Department of Medical Research National Taiwan University Hospital Taipei, Taiwan
SDGs
Other Subjects
bacterial strain; cancer incidence; cohort analysis; cross-sectional study; cryoglobulinemia; ethnic difference; gene mutation; genetic background; Helicobacter; hemochromatosis; hemoglobinopathy; hepatitis C; Hepatitis C virus; high risk population; human; Letter; liver cirrhosis; lymphocyte transformation; lymphoma; nonhodgkin lymphoma; priority journal; risk factor; Taiwan
Publisher
John Wiley and Sons Inc.
Type
letter