Published online 12 June 2008
Haematologica, Vol 93, Issue 8, 1247-1251 doi:10.3324/haematol.12352
Copyright © 2008 by Ferrata Storti Foundation
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Thalassemia Syndromes

Safety and efficacy of pegylated interferon {alpha}-2a and ribavirin for the treatment of hepatitis C in patients with thalassemia

Paul Harmatz1, Maureen M. Jonas2, Janet L. Kwiatkowski3, Elizabeth C. Wright4, Roland Fischer1,8, Elliott Vichinsky1, Patricia J. Giardina5, Ellis J. Neufeld2, John Porter6, Nancy Olivieri7 for the Thalassemia Clinical Research Network

1 Children’s Hospital & Research Center Oakland, Oakland, CA, USA
2 Children’s Hospital Boston, Boston, MA, USA
3 Children’s Hospital of Philadelphia, Philadelphia, PA, USA
4 New England Research Institutes, Watertown, MA, USA
5 New York-Presbyterian Hospital, New York, NY, USA
6 University College London, London, UK
7 University Health Network, Toronto, Canada
8 University Medical Center Hamburg-Eppendorf, Hamburg, Germany

Correspondence: Paul Harmatz, Children’s Hospital & Research Center Oakland, 747 52nd Street, Oakland, CA 94609, USA. E-mail:pharmatz{at}mail.cho.org

Antiviral treatment of hepatitis C virus in thalassemia has raised concerns of ribavirin-induced hemolysis and increased iron loading. This study examined the change in liver iron concentration, transfusion requirement, virological response, and iron-related toxicities after pegylated interferon {alpha}-2a/ribavirin treatment in patients with thalassemia. Median transfusions increased by 44%. However, only 29% (4/14) of patients showed an increase of liver iron concentration > 5mg/g dry wt. and overall liver iron remained stable. One of 4 patients with genotype 2 or 3 demonstrated sustained viral response, compared with 50% with genotype 1 (6/12). No patient developed cardiac, liver or endocrine toxicities, although neutropenia occurred in 52%. The molar efficacy of deferoxamine improved with reduction in liver inflammation on biopsy (p=0.001). In conclusion, antiviral treatment is safe if transfusion requirement, iron toxicities and neutropenia are monitored.

Key words: hepatitis C, iron overload, β thalassemia, pegylated interferon {alpha}, ribavirin.


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E. Angelucci and F. Pilo
Treatment of hepatitis C in patients with thalassemia
Haematologica, August 1, 2008; 93(8): 1121 - 1123.
[Full Text] [PDF]