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Objectives: Direct-acting antiviral agents (DAAs) have successfully eradicated chronic hepatitis C virus (HCV) infection. Since chronic HCV is known to have an increased risk of developing B cell non-Hodgkin lymphoma (B-NHL), successful HCV treatment may have virologic, hepatic, and oncologic benefits for B-NHL. Therefore, this study aimed to determine the efficacy of DAAs combined with chemotherapy in B-NHL patients with chronic HCV in Mongolia. Methods: This case-control study included newly diagnosed B-NHL patients with chronic HCV who received DAAs before chemotherapy (with DAAs group). The other is comprised of controls who have been treated by chemotherapy without DAAs. Patients who received courses of DAAs were monitored by the virological and hepatic responses. Results: Eleven patients received DAAs and none of them developed chemotherapy-associated hepatitis flare. Of the DAAs group, during DAAs treatment, 90.9% were clinically stable. In all cases of DAAs in combination with chemotherapy, the Sustained Viral Response (SVR)12 and 24 were 100%. However, 47.4% of those who received DAAs after chemotherapy developed hepatitis flare during chemotherapy. Patients with hepatitis flare had higher serum level of ALT before chemotherapy (15.7 U/L vs. 40.2 U/L; p = 0.014) than those without. Conclusion: DAAs administration results in a significant clinical benefit to B-NHL patients with chronic HCV.

Summary: Chronic HCV infection remains a global health concern due to its involvement in hepatic and extrahepatic diseases, including B cell non-Hodgkin lymphoma (BNHL). Clinical and epidemiological evidence support a causal role for HCV in BNHL development, although mechanistic insight is lacking. We performed RNA-sequencing on peripheral B cells from patients with HCV alone, BNHL alone, and HCV-associated BNHL to identify unique and shared transcriptional profiles associated with transformation. In patients with HCV-associated BNHL, we observed the enrichment of an anergic-like gene signature and evidence of clonal expansion that was correlated with the expression of epigenetic regulatory genes. Our data support a role for viral-mediated clonal expansion of anergic-like B cells in HCV-associated BNHL development and suggest epigenetic dysregulation as a potential mechanism driving expansion. We propose epigenetic mechanisms may be involved in both HCV-associated lymphoma and regulation of B cell anergy, representing an attractive target for clinical interventions.

Objectives: This study was conducted to determine the effect of Hepatitis B infection with or without D coinfection on the hepatitis flare associated with chemotherapy for B-Cell non-Hodgkin lymphoma. Methods: The hepatitis flare related to the chemotherapy for newly diagnosed B-Cell non-Hodgkin lymphoma was studied in HBV mono-infected and HBV and HDV coinfected patients between 2015 and 2018. Results: Nineteen HBsAg positive patients satisfied the inclusion criteria. In the group with the hepatitis flare, 14.3% were anti-HDV negative and 83.3% were anti-HDV positive (p

Objectives: There are several risk factors contribute to the development of the B-cell Non-Hodgkin’s lymphoma (B-NHL) among which hepatitis B, hepatitis C virus (HBV, HCV) infection, as well as old age, are known to have a signi cant effect. Previous studies examining the relationship between HBV, HCV infection and B-NHL show inconsistent results in different endemic areas. Methods: We compared the hepatitis B surface antigen (HBsAg) and antibody against the HCV (anti-HCV) positive incidences among aged 40 years or older patients who have been newly diagnosed with B-NHL, between 2015 and 2018, to prevalence of hepatitis B and C virus infection in the general population of Mongolia in the same age by data of the general population in hepatitis screening and the results of previous studies on the Mongolian population. Results: A total of 187 patients, newly diagnosed with B-NHL ≥40years of age took part in our study. In case of these two groups, the prevalence of HBsAg in the B-NHL population was close to the general population while anti-HCV positive was signi cantly higher in the B-NHL group (p

Objectives: For last 5 years, we have focused on establishing autologous stem cell transplantation (ASCT) in Mongolia. Herein, we report on three Mongolian multiple myeloma (MM) cases treated with bortezomib and dexamethasone (VD) prior to ASCT. Methods: The MM diagnosis was confirmed by bone marrow aspiration, urine protein electrophoresis, and serum protein electrophoresis. Results: Circulating white blood cells appeared 8-10 days after ASCT. Platelet levels recovered 10 -15 days after ASCT. Conclusion: In our MM cases, the VD regimen prior to ASCT obtained good response rates without the impairment of stem cells.

Objectives: Waldenstrom Macroglobulinemia (WM) is a malignant disease of the B lymphocytes. We report on a patient in Mongolia having WM complicated with hyperviscosity syndrome. Methods: A 28 year-old Mongolian woman had symptoms due to hyperviscosity syndrome such as vision loss, headache, dizziness and, epistaxis. Upon examination, her morphology, biochemistry, histology, flow cytometry and serum protein electrophoresis indicated WM complicated with hyperviscosity syndrome. Results: The patient was was successfully treated with a combination chemotherapy and plasmapheresis. Conclusion: Hyperviscosity syndrome manifestations should be treated with plasmapheresis.