Department of Hemostaseology and Transfusion Medicine, Medical Center of University Düsseldorf, Düsseldorf, Germany.
Clin Hemorheol Microcirc. 2010;44(2):137-44. doi: 10.3233/CH-2010-1262.
Thrombocytopenia is commonly observed during interferon-alpha (IFN-alpha) therapy in patients with chronic hepatitis C. Since thrombopoietin (TPO) is the main regulator of thrombopoiesis, thrombocytopenia may partially be due to a reduced TPO generation. Because of the developments of the second generation of TPO mimetic drugs patients with reduced TPO levels should be identified possibly having a benefit by medicinal stimulation of thrombopoiesis. Therefore, platelet count and serum TPO concentration of patients receiving an interferon-alpha therapy were determined.Twelve patients treated with IFN-alpha (daily 10 x 106 IU s.c. for four weeks) in cause of chronic hepatitis C were examined during the first month of therapy. Serum TPO concentration significantly decreased from 80.8+/-48.0 to 34.6+/-24.5 pg/ml (p<0.05, Mann-Whitney test), and platelet count declined from 214,417+/-48,292 to 151,333+/-44,726 platelets/microl. During the following three weeks platelet count remained at a low level, while serum TPO increased to normal range.In conclusion, an interferon treatment causes reduced serum TPO level during the first week of therapy accompanied by decreased platelet count. The reduction in TPO synthesis contributes to the development of thrombocytopenia in patients during interferon therapy.
血小板减少症在慢性丙型肝炎患者接受干扰素-α（IFN-α）治疗期间很常见。由于血小板生成素（TPO）是血小板生成的主要调节剂，因此血小板减少症可能部分归因于 TPO 生成减少。由于第二代 TPO 模拟药物的发展，应该识别出 TPO 水平降低的患者，通过促进血小板生成来获得治疗益处。因此，测定了接受干扰素-α治疗的患者的血小板计数和血清 TPO 浓度。
在患有慢性丙型肝炎的 12 例患者中，在 IFN-α治疗的第一个月期间进行了检查（每天皮下注射 10×106IU，持续四周）。血清 TPO 浓度从 80.8±48.0 降至 34.6±24.5pg/ml（p<0.05，Mann-Whitney 检验），血小板计数从 214417±48292 降至 151333±44726 个/μl。在接下来的三周内，血小板计数仍处于低水平，而血清 TPO 增加到正常范围。
总之，干扰素治疗在治疗的第一周会导致血清 TPO 水平降低，同时血小板计数降低。TPO 合成减少导致干扰素治疗期间患者发生血小板减少症。
