TY - JOUR
T1 - Feasibility of pegylated interferon and ribavirin in hepatitis C-related cirrhosis with neutropenia or thrombocytopenia
AU - Iacobellis, Angelo
AU - Cozzolongo, Raffaele
AU - Minerva, Nicola
AU - Valvano, Maria Rosa
AU - Niro, Grazia Anna
AU - Fontana, Rosanna
AU - Palmieri, Orazio
AU - Ippolito, Antonio
AU - Andriulli, Angelo
PY - 2014
Y1 - 2014
N2 - Aim: To investigate the feasibility of pegylated interferon plus ribavirin treatment in cirrhotic patients who presented with, or developed while on-treatment, platelet counts ≤80,000/μL and/or neutrophil counts ≤1500/μL. Methods: A retrospective analysis of prospectively gathered data on 123 cirrhotic patients treated with pegylated interferon and ribavirin. Adverse effects and haematological changes were monitored: bleeding and infectious events were registered and related to platelet and absolute neutrophil counts. Results: Among the 58 patients (47.2%) with nadir platelets ≤50,000/μL during therapy, 6 (10.3%) experienced a bleeding episode; of the remaining 65 patients with platelets constantly >50,000/μL, 3 (4.6%) bled. Of the 11 bleedings, 3 manifested during an infection, while patients had platelets >50,000/μL. Nadir neutrophils ≤750/μL occurred in 45 patients (38.2%) during treatment, and 14 of them (29.8%) had an infectious event. Infections were also documented in 18 of the 76 patients (23.7%) with neutrophils constantly >750/μL. Conclusions: The study reveals the feasibility of treating cirrhotic patients with cytopenia with pegylated interferon and ribavirin, as bleeding or infectious events under therapy were unrelated to platelet and neutrophil counts. Withdrawal of therapy or variations in the pre-assigned dosages of either pegylated interferon or ribavirin owing to abnormally low haematological parameters seems to no longer be tenable.
AB - Aim: To investigate the feasibility of pegylated interferon plus ribavirin treatment in cirrhotic patients who presented with, or developed while on-treatment, platelet counts ≤80,000/μL and/or neutrophil counts ≤1500/μL. Methods: A retrospective analysis of prospectively gathered data on 123 cirrhotic patients treated with pegylated interferon and ribavirin. Adverse effects and haematological changes were monitored: bleeding and infectious events were registered and related to platelet and absolute neutrophil counts. Results: Among the 58 patients (47.2%) with nadir platelets ≤50,000/μL during therapy, 6 (10.3%) experienced a bleeding episode; of the remaining 65 patients with platelets constantly >50,000/μL, 3 (4.6%) bled. Of the 11 bleedings, 3 manifested during an infection, while patients had platelets >50,000/μL. Nadir neutrophils ≤750/μL occurred in 45 patients (38.2%) during treatment, and 14 of them (29.8%) had an infectious event. Infections were also documented in 18 of the 76 patients (23.7%) with neutrophils constantly >750/μL. Conclusions: The study reveals the feasibility of treating cirrhotic patients with cytopenia with pegylated interferon and ribavirin, as bleeding or infectious events under therapy were unrelated to platelet and neutrophil counts. Withdrawal of therapy or variations in the pre-assigned dosages of either pegylated interferon or ribavirin owing to abnormally low haematological parameters seems to no longer be tenable.
KW - Antiviral treatment
KW - Bleeding
KW - HCV
KW - Infections
KW - Liver cirrhosis
KW - Neutrophils
KW - Platelets
UR - http://www.scopus.com/inward/record.url?scp=84903820767&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84903820767&partnerID=8YFLogxK
U2 - 10.1016/j.dld.2014.02.001
DO - 10.1016/j.dld.2014.02.001
M3 - Article
C2 - 24675038
AN - SCOPUS:84903820767
VL - 46
SP - 621
EP - 624
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 7
ER -