Bone marrow suppression or active proliferation? An analysis of neutropenia after pegylated interferon treatment of patients with chronic hepatitis C. (December 2013)

• Record Type: Journal Article
• Authors: Liu, Ya-Li; Du, Xiao-Fei; Chen, Xin-Yue; Ma, Li-Na; Guo, Dan-Dan; Lu, Jun-Feng; Cao, Zhen-Huan; Zhang, Yong-Hong
• Is Part Of: Scandinavian journal of infectious diseases. Volume 45:Number 12(2013:Dec.)
• Page Start: 939
• Page End: 943
• Publication Date: 2013-12
• Subjects: Communicable diseases -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.3109/00365548.2013.835067
• Languages: English
• ISSNs: 0036-5548

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background:</italic> Neutropenia is a common adverse effect of the treatment of chronic hepatitis C with pegylated interferon and ribavirin. However, the mechanism involved is unknown. The present study aimed to investigate the cause of treatment-induced neutropenia by determining cytokine levels in plasma and in bone marrow smears. <italic>Methods:</italic> Fifteen patients with chronic hepatitis C were enrolled in this study. Plasma cytokine levels were determined using the Luminex assay before and during treatment. We simultaneously determined the levels of granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), and 7 other cytokines, and performed bone marrow cytology when blood cell counts indicated neutropenia. <italic>Results:</italic> Only 1 bone marrow smear indicated a low cell proliferation level, whereas active proliferation was observed in the remaining 14 patients. The levels of G-CSF, GM-CSF, interleukin (IL)-2, IL-4, IL-6, and interferon (IFN)-γ decreased significantly in patients with neutropenia (<italic>p</italic> < 0.05). In contrast, the levels of IL-8, IL-10, and tumor necrosis factor (TNF)-α showed no significant change (<italic>p</italic> = 0.713, 0.930, 0.833, respectively) before or after treatment. <italic>Conclusions:</italic> The bone marrow of most patients with IFN-induced neutropenia showed active cell proliferation. Elevated G-CSF and GM-CSF but not bone marrow suppression was observed along with neutropenia after pegylated interferon treatment, suggesting a causative role of G-CSF and GM-CSF in neutropenia.</p> </abstract>