Thrombocytopenia, an Important Interfering Factor of Antiviral Therapy and Hepatocellular Carcinoma Treatment for Chronic Liver Diseases

• KAWAGUCHI TAKUMI

  Department of Digestive Disease Information & Research, Kurume University School of Medicine Department of Medicine, Kurume University School of Medicine

• KURUMATSU RYOKO

  Department of Medicine, Kurume University School of Medicine

• IDE TATSUYA

  Department of Digestive Disease Information & Research, Kurume University School of Medicine Department of Medicine, Kurume University School of Medicine

• TANIGUCHI EITARO

  Department of Medicine, Kurume University School of Medicine

• ITOU MINORU

  Department of Medicine, Kurume University School of Medicine

• SAKATA MASAHIRO

  Department of Medicine, Kurume University School of Medicine

• ABE MITSUHIKO

  Department of Medicine, Kurume University School of Medicine

• SUMIE SHUJI

  Department of Medicine, Kurume University School of Medicine

• SATA MICHIO

  Department of Digestive Disease Information & Research, Kurume University School of Medicine Department of Medicine, Kurume University School of Medicine

抄録

In patients with chronic liver diseases, thrombocytopenia is a common manifestation which interferes with antiviral therapy for hepatitis C virus (HCV), and with hepatocellular carcinoma (HCC) treatment. While thrombopoietin-receptor agonist is expected to improve thrombocytopenia for patients with chronic liver diseases in 2-3 weeks, there is still a lack of fundamental data about short-term variations in the natural course of platelet count in cirrhotic patients, and the impact of thrombocytopenia on antiviral therapy for HCV-infected patients and patients being treated for HCC. The aims of this study are to investigate sequential changes in platelet count and the impact of thrombocytopenia on antiviral therapy and HCC treatment in patients with chronic liver diseases. A total of 726 chronic liver disease patients were enrolled in this study. Changes of platelet count were examined during a 4-week follow-up. Risk of discontinuation or reduction of peginterferon dosage was evaluated in HCV patients with moderate thrombocytopenia (5-10×10⁴/μL). Risk of platelet transfusion or splenectomy was evaluated in HCC patients with severe thrombocytopenia (<5×10⁴/μL). No significant changes of platelet count were observed in cirrhotic patients with thrombocytopenia during a 4-week follow-up. The rate of discontinuation or reduction in dosage of peginterferon was 85.2% (23/27) in patients with moderate thrombocytopenia. Risk of discontinuation or reduction of peginterferon dosage was 3.4-times higher in HCV patients with thrombocytopenia than in those without thrombocytopenia. In HCC patients with severe thrombocytopenia, the frequency of platelet transfusion or splenectomy during HCC treatment was 57.9% (22/38). Risk of platelet transfusion or splenectomy in HCC patients with thrombocytopenia was 57.9-times higher than in those without thrombocytopenia. In conclusion, we demonstrated no significant variation in the short-term natural course of platelet count in cirrhotic patients. In chronic liver disease patients with moderate and severe thrombocytopenia, about 85% of patients treated with peginterferon, and 60% of patients receiving HCC treatments suffered from thrombocytopenia-related limitations, respectively.

収録刊行物

• Ｔｈｅ　Ｋｕｒｕｍｅ　Ｍｅｄｉｃａｌ　Ｊｏｕｒｎａｌ

  Ｔｈｅ　Ｋｕｒｕｍｅ　Ｍｅｄｉｃａｌ　Ｊｏｕｒｎａｌ 56 (1/2), 9-15, 2009

  久留米大学医学部 The Kurume Medical Journal 編集部

キーワード

• eltrombopag
• thrombocytopenia
• peginterferon
• hepatocellular carcinoma
• liver cirrhosis

詳細情報

• CRID: 1390001206344885120
• NII論文ID: 130000168343
• DOI: 10.2739/kurumemedj.56.9
• ISSN: 18812090
• ISSN: 00235679
• Web Site: https://search.jamas.or.jp/link/ui/2010166730
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• 抄録ライセンスフラグ: 使用不可