Lodato F, Azzaroli F, Tamè MR, Girolamo MD, Buonfiglioli F, Mazzella N, Cecinato P, Roda E, Mazzella G. G-CSF in Peg-IFN induced neutropenia in liver transplanted patients with HCV recurrence. World J Gastroenterol 2009; 15(43): 5449-5454 [PMID: 19916175 DOI: 10.3748/wjg.15.5449]
Corresponding Author of This Article
Dr. Francesca Lodato, MD, Department of Digestive Diseases and Internal Medicine, Sant’Orsola-Malpighi University Hospital, Via Massarenti, Bologna 40138, Italy. francesca.lodato@unibo.it
Article-Type of This Article
Brief Article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Nov 21, 2009; 15(43): 5449-5454 Published online Nov 21, 2009. doi: 10.3748/wjg.15.5449
Table 1 Baseline characteristics of patients at enrolment
Sex (M/F)
46/22
Age, median (range)
59 (22-68)
BMI, median (range)
24.2 (15.5-40.5)
Months since LT, median (range)
15.5 (1-151)
Previous acute cellular rejection n (%)
13 (19)
Days since OLT, mean
36.4
Previous CMV infection n (%)
14 (21)
Genotype n (%)
1
53 (76.5)
2
6 (9)
3
4 (6)
4
5 (7)
Viral load (MEq/mL), median (range)
10.6 (0.009-40)
ALT (IU/L), median (range)
136 (52-945)
Neutrophil count (× 103/mmc) mean ± SD
3 ± 1.2
Hemoglobin (g/dL) mean ± SD
12.9 ± 1.5
Cirrhosis n (%)
10 (15)
Pre-LT antiviral treatment n (%)
29 (45)
Post-LT antiviral treatment n (%)
15 (22)
Induction immunosuppression n (%)
Monoclonal antibodies
10 (14)
Steroids
49 (72)
Other
3 (4)
NA
6 (10)
Maintenance immunosuppression n (%)
Cyclosporine
30 (44)
Tacrolimus
22 (32)
Cyclosporine + steroids
6 (9)
Tacrolimus + steroids
9 (13)
Other
1 (1.5)
Table 2 Characteristics of patients developing neutropenia
G-CSF
No G-CSF
P
Sex (M/F)
10/13
Dec-33
NS
Age, median (range)
60 (41-68)
58 (22-67)
NS
Months since LT, median (range)
15 (2-151)
19 (1-148)
Genotype n (%)
1
17 (73)
36 (80)
NS
2
2 (8.6)
4 (8.8)
NS
3
2 (8.6)
2 (4.4)
NS
4
2 (8.6)
3 (6.6)
NS
Neutrophil count (× 103/mmc) mean ± SD
2.23 ± 0.96
3.14 ± 1.22
0.0021
Cirrhosis n (%)
10 (15)
Induction immunosuppression n (%)
Monoclonal antibodies
4 (17)
6 (13)
NS
Steroids
17 (73)
32 (71)
NS
Other
1 (3)
2 (4)
NS
NA
1 (3)
5 (1)
NS
Maintenance immunosuppression n (%)
Cyclosporine
10 (43)
20 (44)
NS
Tacrolimus
8 (34)
14 (31)
NS
Cyclosporine + steroids
1 (4)
5 (11)
NS
Tacrolimus + steroids
3 (13)
6 (13)
NS
Other
1 (4)
0
NS
Table 3 Peg-IFN and RBV dose reductions n (%)
G-CSF
No G-CSF
P
RBV reduction
6 (26)
17 (37)
0.4
RBV withdrawal
4 (17)
3 (6)
0.2
Peg-IFN + RBV reduction
2 (8)
1 (2)
0.2
Table 4 Causes of premature discontinuation in the two groups
Discontinuation cause
G-CSF group
Non neutropenic group
Liver decompensation
3
3
Severe asthenia
2
1
Neutropenia
1
Anemia
1
Toxic hepatitis
1
Non response
1
Liver abscess
1
De novo AIH
9
De novo HBV infection
1
Citation: Lodato F, Azzaroli F, Tamè MR, Girolamo MD, Buonfiglioli F, Mazzella N, Cecinato P, Roda E, Mazzella G. G-CSF in Peg-IFN induced neutropenia in liver transplanted patients with HCV recurrence. World J Gastroenterol 2009; 15(43): 5449-5454