G-CSF in Peg-IFN induced neutropenia in liver transplanted patients with HCV recurrence.
OBJECTIVE
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).


CONCLUSIONS
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.
Lodato
Francesca
F
Department of Digestive Diseases and Internal Medicine, University of Bologna, Bologna 40138, Italy. francesca.lodato@unibo.it
Azzaroli
Francesco
F
Tamè
Maria-Rosa
MR
Di Girolamo
Maria
M
Buonfiglioli
Federica
F
Mazzella
Natalia
N
Cecinato
Paolo
P
Roda
Enrico
E
Mazzella
Giuseppe
G
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000494:pharmacology; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000378:metabolism*; D016174:Hepacivirus / Q000378:metabolism; D006526:Hepatitis C / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced*; D009504:Neutrophils / Q000187:drug effects; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011183:Postoperative Complications; D011994:Recombinant Proteins; D012008:Recurrence
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b