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Treatment of hepatitis C related thrombocytopenia with interferon alpha

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  • claudine intexas
    Online ISSN: 1096-8652 Print ISSN: 0361-8609 American Journal of Hematology Volume 68, Issue 3, 2001. Pages: 202-209 Published Online: 23 Oct 2001 Copyright ©
    Message 1 of 1 , Dec 2, 2001
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      Online ISSN: 1096-8652 Print ISSN: 0361-8609
      American Journal of Hematology
      Volume 68, Issue 3, 2001. Pages: 202-209

      Published Online: 23 Oct 2001
      Copyright � 2001 Wiley-Liss,Inc.
      --------------------------------------------------------------------------------

      Case Report
      Treatment of hepatitis C related thrombocytopenia with
      interferon alpha
      Sandeep Rajan, Howard A. Liebman *
      Division of Hematology, Department of Medicine,
      University of Southern California-Keck School of
      Medicine, Los Angeles, California

      email: Howard A. Liebman (liebman@...)

      *Correspondence to Howard A. Liebman, Division of
      Hematology, Kenneth Norris Jr Cancer Center, MS 34,
      1441 Eastlake Ave., Los Angeles, CA 90033

      Keywords
      thrombocytopenia; hepatitis C; interferon alpha

      Abstract
      Thrombocytopenia is a common extrahepatic
      manifestation of hepatitis C (HCV) infection.
      Treatment with steroids may be effective, but can
      exacerbate the viral infection. Interferon alpha (INF)
      has documented efficacy in the treatment of HCV, but
      its use in the treatment of HCV thrombocytopenia is
      controversial. We treated eight patients with
      HCV-related thrombocytopenia, who had platelet counts
      of fewer than 50 � 109/l (range: 16 to 46 � 109/L)
      with INF 3 MU SQ three times a week. Planned duration
      of treatment was 24 weeks. Five patients had no
      evidence of hepatic cirrhosis, three had cirrhosis,
      and two had palpable splenomegaly. Only three patients
      tolerated the full course of treatment, and all three
      had improvement in their platelet counts to greater
      than 50 � 109/l. Two other patients had improvement in
      platelet counts to more than 50 � 109/l with shorter
      duration of treatment (six and 16 weeks,
      respectively). The mean increase in platelet count in
      the five responders was 44 � 109/lL (range: 28 to 90 �
      109/l). The average peak platelet count in the
      responders was 81 � 109/l (range: 62 to 136 � 109/l).
      Duration of response ranged from four to 18+ months,
      with the shortest responses observed in the two
      patients treated with a shorter course of INF.
      Response was independent of the presence of cirrhosis.
      Responding patients had improvement in hepatic
      transaminases, reduction in cryoglobulin and
      anticardiolipin antibodies, and HCV plasma RNA when
      tested. Relapse was associated with an increase in
      these laboratory markers of HCV infection. We conclude
      that INF can be an effective treatment in patients
      with HCV-related thrombocytopenia. Am. J. Hematol.
      68:202-209, 2001. � 2001 Wiley-Liss, Inc.

      Received: 20 October 2000; Accepted: 15 June 2001


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