The impact of previous or concomitant IFN therapy on deferiprone-induced agranulocytosis and neutropenia: a retrospective study.

Abstract

OBJECTIVE:

Although IFN therapy is known to cause neutropenia, data on the risk of deferiprone (DFP)-induced haematological complications in patients receiving IFN are lacking.

RESEARCH DESIGN AND METHODS:

This was a retrospective single-centre study to assess the association between exposure to IFN for hepatitis C virus treatment and haematological side effects of DFP therapy in patients with thalassemia major and intermedia using a large database spanning 2001 – 2008. During observation time, a total of 66 patients, including 63 affected by thalassemia major and 3 by thalassemia intermedia, were treated with chelation DFP-based regimens. A subset of 25 patients was treated at least for 3 months also with IFN (6 were cotreated and 19 were pretreated).

RESULTS:

Overall, the incidence of neutropenia and agranulocytosis was 9.83 and 1.14/100 patient/year, respectively. Receipt of IFN was significantly associated with increased risk of haematological complications of DFP therapy: among patients receiving IFN, 48 and 12% experienced at least one episode of neutropenia and agranulocytosis, respectively.

CONCLUSIONS:

These results suggest that IFN therapy may increase the risk of complications of DFP-based iron chelation therapy in patients with thalassemia. Further research is needed to assess whether the association observed in this retrospective single-centre observational study is due to IFN or other factors.

• Authors: Paolo Ricchi, Massimiliano Ammirabile, Silvia Costantini, Patrizia Cinque, Alfonso Galeota Lanza, Anna Spasiano, Tiziana Di Matola, Giovanni Di Costanzo, Leonilde Pagano, Luciano Prossomariti
• Journal: Expert opinion on drug safety (Expert Opin Drug Saf) Vol. 9 Issue 6 Pg. 875-81 (Nov 2010) ISSN: 1744-764X [Electronic] England
• PMID: 20945995 (Publication Type: Journal Article)

Chemical References

• Antiviral Agents
• Interferon alpha-2
• Interferon-alpha
• Pyridones
• Recombinant Proteins
• Siderophores
• Deferiprone
• Polyethylene Glycols
• peginterferon alfa-2b
• Deferoxamine

Topics

• Adult
• Agranulocytosis (chemically induced)
• Antiviral Agents (therapeutic use)
• Deferiprone
• Deferoxamine (therapeutic use)
• Drug Therapy, Combination
• Female
• Hepatitis C, Chronic (drug therapy)
• Humans
• Interferon alpha-2
• Interferon-alpha (adverse effects, therapeutic use)
• Male
• Middle Aged
• Neutropenia (chemically induced)
• Polyethylene Glycols (adverse effects, therapeutic use)
• Pyridones (adverse effects)
• Recombinant Proteins
• Retrospective Studies
• Siderophores (therapeutic use)
• beta-Thalassemia (drug therapy)