Treatment of hepatitis C related thrombocytopenia with interferon alpha
- 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.
Treatment of hepatitis C related thrombocytopenia with
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
thrombocytopenia; hepatitis C; interferon alpha
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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