ABSTRACT
Chronic hepatitis C virus (HCV) infection is not uncommon in patients with acute leukemia due to frequent blood transfusions. The treatment of HCV in patients with acute leukemia can produce profound immune dysfunction with the risk of severe cytopenia. We report the case of a young man who was treated with combined therapy of peginterferon α 2a and ribavirin for HCV while he was on maintenance anti-leukemic treatment. The patient required reduction in the dose of peginterferon α 2a and the addition of filgrastim due to neutropenia. Therapy for HCV was continued for 72 weeks and at the end of therapy, the patient had undetectable HCV RNA. The patient maintained a sustained viral response two years after the end of therapy and developed complete remission of leukemia, whereupon his anti-leukemic therapy was also discontinued. We recommend conducting further large prospective studies in HCV patients treated for leukemia to determine the safety and efficacy of antiviral therapy in this group of patients.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antiviral Agents/administration & dosage , Hepatitis C, Chronic/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Administration, Oral , Follow-Up Studies , Hepatitis C, Chronic/complications , Hepatitis C, Chronic/diagnosis , Humans , Injections, Subcutaneous , Interferon alpha-2 , Interferon-alpha/administration & dosage , Male , Mercaptopurine/administration & dosage , Polyethylene Glycols/administration & dosage , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Recombinant Proteins , Ribavirin/administration & dosage , Risk Assessment , Severity of Illness Index , Treatment Outcome , Vincristine/administration & dosage , Young AdultABSTRACT
The objective of this case series was to determine the efficacy and safety of combined treatment with ribavirin and peginterferon alpha-2a in sickle cell disease (SCD) patients with chronic hepatitis C virus (HCV) hepatitis. Eight patients in King Abdulaziz Hospital & Oncology Center, Jeddah, Kingdom of Saudi Arabia from 2003 and 2006 with chronic HCV infection were treated with peginterferon alpha-2a and ribavirin for one year. All 8 patients had a complete early virological response. Seven out of 8 had an end of treatment response with undetectable HCV RNA at the end of therapy, 5 of whom also maintained a sustained virological response when assessed 6 months after the end of treatment. Hemoglobin concentrations measured at one, 3, 6, 9, and 12 months of treatment showed no significant changes from that measured as baseline. Treatment of chronic HCV hepatitis in patients with SCD with peginterferon alpha-2a and ribavirin seems safe and effective.
