Department of Digestive Diseases and Internal Medicine, University of Bologna, Bologna 40138, Italy.
World J Gastroenterol. 2009 Nov 21;15(43):5449-54. doi: 10.3748/wjg.15.5449.
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.
Sixty-eight patients undergoing antiviral treatment for post-liver transplantation (OLT) HCV recurrence were enrolled. All patients developing neutropenia received G-CSF.
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).
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.
评估粒细胞集落刺激因子（G-CSF）在丙型肝炎（HCV）复发和聚乙二醇干扰素α-2b 诱导中性粒细胞减少的肝移植患者中的疗效，并评估 G-CSF 给药对病毒学应答的影响。
纳入 68 例接受抗病毒治疗的肝移植后（OLT）HCV 复发患者。所有发生中性粒细胞减少的患者均接受 G-CSF 治疗。
23 例（34%）接受 G-CSF 治疗。中性粒细胞减少发生时的中性粒细胞计数平均值为 700/mmc（范围 400-750/mmc）；使用 G-CSF 治疗 1 个月后，中性粒细胞计数增加至 1210/mmc（范围 300-5590/mmc）（P<0.0001）。有 3 例患者对 G-CSF 无反应。中性粒细胞减少和非中性粒细胞减少患者的治疗持续时间相似。两组之间在停药率、感染或病毒学应答方面无差异。G-CSF 可预防新发自身免疫性肝炎的发生（P<0.003）。
G-CSF 治疗可有效治疗聚乙二醇干扰素诱导的中性粒细胞减少症，增加中性粒细胞计数，延长治疗时间，并使持续病毒学应答（SVR）率与非中性粒细胞减少患者相当。它可预防新发自身免疫性肝炎的发生。
