Drapeau C M J, Remotti D, Noto P, Capone A, Boumis E, Petrosillo N
2nd Infectious Diseases Division, National Institute for Infectious Diseases L. Spallanzani, Rome, Italy.
J Chemother. 2008 Oct;20(5):648-51. doi: 10.1179/joc.2008.20.5.648.
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.
丙型肝炎病毒（HCV）相关慢性肝炎的最佳治疗方法是聚乙二醇化干扰素α（peg-IFNα）联合利巴韦林（RBV）。不幸的是，peg-IFNα和RBV都会引发多种不良事件和潜在的严重毒性，尤其是血液学改变。实际上，RBV通常通过溶血导致贫血，而peg-IFNα更常引起白细胞减少和血小板减少，推测是通过骨髓毒性作用。事实上，关于HCV感染患者在接受α干扰素治疗后骨髓组织病理学改变的数据很少。我们报告了1例HCV感染的肝硬化患者，在接受1年的peg-IFNα联合RBV治疗后出现骨髓改变，并描述了相关的组织病理学特征。我们的病例报告为HCV感染的肝硬化患者在接受peg-IFNα-2a联合RBV治疗期间骨髓发生的组织病理学变化提供了新的重要见解，也为基于干扰素治疗过程中的潜在骨髓毒性提供了更多信息。
