G-CSF in Peg-IFN Induced Neutropenia in Liver Transplanted Patients with HCV Recurrence

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2009 Nov 17

PMID 19916175

Citations 4

Authors

Francesca Lodato

Francesco Azzaroli

Maria-Rosa Tame

Maria Di Girolamo

Federica Buonfiglioli

Natalia Mazzella

Paolo Cecinato

Enrico Roda

Giuseppe Mazzella

Affiliations

Soon will be listed here.

Abstract

Aim: To evaluate the efficacy of granulocyte colony stimulating factors (G-CSF) in liver transplanted patients with hepatitis C (HCV) recurrence and Pegylated-IFN alpha-2b induced neutropenia, and to evaluate the impact of G-CSF administration on virological response.

Methods: Sixty-eight patients undergoing antiviral treatment for post-liver transplantation (OLT) HCV recurrence were enrolled. All patients developing neutropenia received G-CSF.

Results: Twenty three (34%) received G-CSF. Mean neutrophil count at the onset of neutropenia was 700/mmc (range 400-750/mmc); after 1 mo of G-CSF it increased to 1210/mmc (range 300-5590/mmc) (P < 0.0001). Three patients did not respond to G-CSF. Treatment duration was similar in neutropenic and non-neutropenic patients. No differences in the rate of discontinuation, infections or virological response were observed between the two groups. G-CSF was protective for the onset of de novo autoimmune hepatitis (P < 0.003).

Conclusion: G-CSF administration is effective in the case of Peg-IFN induced neutropenia increasing neutrophil count, prolonging treatment and leading to sustained virological response (SVR) rates comparable to non-neutropenic patients. It prevents the occurrence of de novo autoimmune hepatitis.

Citing Articles

Autoimmune Hepatitis in the Liver Transplant Graft.

Beal E, Black S, Michaels A Clin Liver Dis. 2017; 21(2):381-401.

PMID: 28364820 PMC: 5969577. DOI: 10.1016/j.cld.2016.12.010.

Management of post liver transplantation recurrent hepatitis C infection with directly acting antiviral drugs: a review.

Jothimani D, Govil S, Rela M Hepatol Int. 2016; 10(5):749-61.

PMID: 27337961 DOI: 10.1007/s12072-016-9744-3.

De novo autoimmune hepatitis in liver transplant: State-of-the-art review.

Vukotic R, Vitale G, DErrico-Grigioni A, Muratori L, Andreone P World J Gastroenterol. 2016; 22(10):2906-14.

PMID: 26973387 PMC: 4779914. DOI: 10.3748/wjg.v22.i10.2906.

Hematological Adverse events and Sustained Viral Response in Children Undergoing Therapy for Chronic Hepatitis C Infection.

Pawlowska M, Pilarczyk M, Foksinska A, Smukalska E, Halota W Hepat Mon. 2012; 11(12):968-74.

PMID: 22368680 PMC: 3282029. DOI: 10.5812/kowsar.1735143X.789.

References

Aspinall R, Pockros P . The management of side-effects during therapy for hepatitis C. Aliment Pharmacol Ther. 2004; 20(9):917-29. DOI: 10.1111/j.1365-2036.2004.02192.x. View

Juarez-Navarro A, Vera-de-Leon L, Navarro J, Chirino-Sprung R, Diaz-Hernandez M, Casillas-Davila L . Incidence and severity of infections according to the development of neutropenia during combined therapy with pegylated interferon-alpha2a plus ribavirin in chronic hepatitis C infection. Methods Find Exp Clin Pharmacol. 2005; 27(5):317-22. DOI: 10.1358/mf.2005.27.5.908646. View

Soza A, Everhart J, Ghany M, Doo E, Heller T, Promrat K . Neutropenia during combination therapy of interferon alfa and ribavirin for chronic hepatitis C. Hepatology. 2002; 36(5):1273-9. DOI: 10.1053/jhep.2002.36502. View

Still B, Amano M, Zukor J, Negrin R, Blume K, Strober S . Granulocyte colony-stimulating factor-induced comobilization of CD4- CD8- T cells and hematopoietic progenitor cells (CD34+) in the blood of normal donors. Blood. 1997; 89(7):2586-95. View

Berardi S, Lodato F, Gramenzi A, DErrico A, Lenzi M, Bontadini A . High incidence of allograft dysfunction in liver transplanted patients treated with pegylated-interferon alpha-2b and ribavirin for hepatitis C recurrence: possible de novo autoimmune hepatitis?. Gut. 2006; 56(2):237-42. PMC: 1856781. DOI: 10.1136/gut.2006.092064. View

Antonini M, Babudieri S, Maida I, Baiguera C, Zanini B, Fenu L . Incidence of neutropenia and infections during combination treatment of chronic hepatitis C with pegylated interferon alfa-2a or alfa-2b plus ribavirin. Infection. 2008; 36(3):250-5. DOI: 10.1007/s15010-007-7132-6. View

Collantes R, Younossi Z . The use of growth factors to manage the hematologic side effects of PEG-interferon alfa and ribavirin. J Clin Gastroenterol. 2004; 39(1 Suppl):S9-13. DOI: 10.1097/01.mcg.0000142583.00102.45. View

Zavala F, Masson A, Hadaya K, Ezine S, Schneider E, Babin O . Granulocyte-colony stimulating factor treatment of lupus autoimmune disease in MRL-lpr/lpr mice. J Immunol. 1999; 163(9):5125-32. View

Manns M, McHutchison J, Gordon S, Rustgi V, Shiffman M, Reindollar R . Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet. 2001; 358(9286):958-65. DOI: 10.1016/s0140-6736(01)06102-5. View

10.

Thomas R, Brems J, Guzman-Hartman G, Yong S, Cavaliere P, Van Thiel D . Infection with chronic hepatitis C virus and liver transplantation: a role for interferon therapy before transplantation. Liver Transpl. 2003; 9(9):905-15. DOI: 10.1053/jlts.2003.50166. View

11.

Dejaco C, Lichtenberger C, Miehsler W, Oberhuber G, Herbst F, Vogelsang H . An open-label pilot study of granulocyte colony-stimulating factor for the treatment of severe endoscopic postoperative recurrence in Crohn's disease. Digestion. 2003; 68(2-3):63-70. DOI: 10.1159/000074517. View

12.

Rutella S, Zavala F, Danese S, Kared H, Leone G . Granulocyte colony-stimulating factor: a novel mediator of T cell tolerance. J Immunol. 2005; 175(11):7085-91. DOI: 10.4049/jimmunol.175.11.7085. View

13.

McHutchison J, Manns M, Patel K, Poynard T, Lindsay K, Trepo C . Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C. Gastroenterology. 2002; 123(4):1061-9. DOI: 10.1053/gast.2002.35950. View

14.

Rodriguez-Luna H, Khatib A, Sharma P, De Petris G, Williams J, Ortiz J . Treatment of recurrent hepatitis C infection after liver transplantation with combination of pegylated interferon alpha2b and ribavirin: an open-label series. Transplantation. 2004; 77(2):190-4. DOI: 10.1097/01.TP.0000100481.14514.BB. View

15.

Lawlor K, Campbell I, Metcalf D, ODonnell K, Van Nieuwenhuijze A, Roberts A . Critical role for granulocyte colony-stimulating factor in inflammatory arthritis. Proc Natl Acad Sci U S A. 2004; 101(31):11398-403. PMC: 509212. DOI: 10.1073/pnas.0404328101. View

16.

Fried M . Side effects of therapy of hepatitis C and their management. Hepatology. 2002; 36(5 Suppl 1):S237-44. DOI: 10.1053/jhep.2002.36810. View

17.

Dumortier J, Scoazec J, Chevallier P, Boillot O . Treatment of recurrent hepatitis C after liver transplantation: a pilot study of peginterferon alfa-2b and ribavirin combination. J Hepatol. 2004; 40(4):669-74. DOI: 10.1016/j.jhep.2003.12.015. View

18.

Rutella S, Bonanno G, Pierelli L, Mariotti A, Capoluongo E, Contemi A . Granulocyte colony-stimulating factor promotes the generation of regulatory DC through induction of IL-10 and IFN-alpha. Eur J Immunol. 2004; 34(5):1291-302. DOI: 10.1002/eji.200324651. View

19.

Lodato F, Tame M, Colecchia A, Racchini C, Azzaroli F, DErrico A . Systemic lupus erythematosus following virological response to peginterferon alfa-2b in a transplanted patient with chronic hepatitis C recurrence. World J Gastroenterol. 2006; 12(26):4253-5. PMC: 4087386. DOI: 10.3748/wjg.v12.i26.4253. View

20.

Piselli P, Zanfi C, Corazza V, Ferretti S, Scuderi M, Arana M . Incidence and timing of infections after liver transplant in Italy. Transplant Proc. 2007; 39(6):1950-2. DOI: 10.1016/j.transproceed.2007.05.056. View