title: Bone marrow toxicity in HCV genotype 5a-infected patient after peg-IFN alpha-2a and ribavirin therapy.
abstract: The optimal therapy for HCV-related chronic hepatitis is the combination of pegylated interferon alpha (peg-IFN alpha) plus ribavirin (RBV). Unfortunately, both peg-IFN alpha and RBV are responsible for a wide range of adverse events and potentially severe toxicities, particularly hematological alterations. Indeed, RBV is generally responsible for anemia through hemolysis, while peg-IFN alpha induces more commonly leukopoenia and thrombocytopenia, presumably through bone marrow toxicity. Actually, data regarding histopathological bone marrow alterations in HCV-infected patients following IFN-alpha therapy is scanty. We report a case of a HCV-infected cirrhotic patient, who developed bone marrow alterations following one-year peg-IFN alpha plus RBV treatment, and we describe the associated histopathological features. Our case report provides new significant insight on the histopathological changes occurring in bone marrow of HCV-infected cirrhotic patients during peg-IFN alpha-2a plus RBV treatment, providing also additional information on potential bone marrow toxicity in the course of IFN-based treatments.
authors.affiliation: 2nd Infectious Diseases Division, National Institute for Infectious Diseases L. Spallanzani, Rome, Italy.
authors.forename: C M J
authors.initials: CM
authors.lastname: Drapeau
authors.forename: D
authors.initials: D
authors.lastname: Remotti
authors.forename: P
authors.initials: P
authors.lastname: Noto
authors.forename: A
authors.initials: A
authors.lastname: Capone
authors.forename: E
authors.initials: E
authors.lastname: Boumis
authors.forename: N
authors.initials: N
authors.lastname: Petrosillo
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects*; D001853:Bone Marrow / Q000187:drug effects; D001855:Bone Marrow Diseases / Q000139:chemically induced*; D005355:Fibrosis / Q000821:virology; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000139:chemically induced; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects*
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a