31 January 2024

New treatment possibilities have emerged, inspired by a patient with multiple myeloma who appeared to be cured after treatment for hepatitis.

Hepatitis C and B infection should be considered as a potential cause of this type of cancer, according to a new study. Early identification of an infection with these viruses can help doctors to prescribe appropriate treatment before it leads to malignant pathologies, according to the researchers.

The research team was jointly led by Spanish researchers Joaquín Martínez and María Linares, from the H12O-CNIO Haematological Tumours Clinical Research Unit, along with Sylvie Hermouet from the University of Nantes, France.

Their work was inspired by a case from a few years ago of a patient who went into remission from multiple myeloma after being treated for hepatitis C with anti-viral drugs.

The team examined the theory that attributes the cause of multiple myeloma to the chronic exposure to an infectious agent. They wanted to establish whether hepatitis viruses are a direct cause of the disease.

It was believed that the excessive overproduction of a single antibody – monoclonal gammopathy – could be due to chronic exposure to the infectious agent.

The researchers say the case of the cured patient seems to support this theory. They believe the case suggested the body was no longer chronically exposed to the hepatitis virus because the antiviral drug eliminated it, which is why the myeloma disappeared.

To investigate this further, they carried out two studies, including 54 patients with monoclonal gammopathy and hepatitis, of whom there were nine patients with hepatitis C in an initial study, and a second one with 45 patients with hepatitis B.

According to the findings, published in the journal Haematologica, in most of the people infected with hepatitis B, the antibody that was being consistently and excessively produced was found to be targeting the hepatitis B virus.

The team went on to analyse more than 1,300 multiple myeloma patients infected with hepatitis B and more than 1,200 with hepatitis C. In both cohorts, they concluded that in those who received antiviral treatment “the probability of survival was significantly higher”.

The authors say: “In patients infected with the hepatitis B or hepatitis C virus, multiple myeloma or gammopathy may be caused by these viruses, and the study demonstrates the importance of antiviral treatment in these patients.”

An editorial in Haematologica says: “The recognition of this association between viral hepatitis and multiple myeloma, as well as the pathologies known to precede the appearance of myeloma, monoclonal gammopathies, has important clinical implications.”

It adds: “The association between viral hepatitis and the development of multiple myeloma and other monoclonal gammopathies has become an important field of research. Chronic hepatitis B or hepatitis C virus infections contribute to the pathogenesis of these haematological neoplasms, which justifies an increase in awareness, detection and treatment strategies.”


Rodríguez-García A, Mennesson N, Hernandez-Ibarburu G, Morales ML, Garderet L, Bouchereau L, Allain-Maillet S, Piver E, Marbán I, Rubio D, Bigot-Corbel E, Martínez-López J, Linares M, Hermouet S. (2024) “Impact of viral hepatitis therapy in multiple myeloma and other monoclonal gammopathies linked to hepatitis B or C viruses.” Haematologica, doi: 10.3324/haematol.2023.283096

Link: https://haematologica.org/article/view/haematol.2023.283096

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