G-CSF in Peg-IFN induced neutropenia in liver transplanted patients with HCV recurrence

Table 1 Baseline characteristics of patients at enrolment

Sex (M/F)	46/22
Age, median (range)	59 (22-68)
BMI, median (range)	24.2 (15.5-40.5)
Months since LT, median (range)	15.5 (1-151)
Previous acute cellular rejection n (%)	13 (19)
Days since OLT, mean	36.4
Previous CMV infection n (%)	14 (21)
Genotype n (%)
1	53 (76.5)
2	6 (9)
3	4 (6)
4	5 (7)
Viral load (MEq/mL), median (range)	10.6 (0.009-40)
ALT (IU/L), median (range)	136 (52-945)
Neutrophil count (× 103/mmc) mean ± SD	3 ± 1.2
Hemoglobin (g/dL) mean ± SD	12.9 ± 1.5
Cirrhosis n (%)	10 (15)
Pre-LT antiviral treatment n (%)	29 (45)
Post-LT antiviral treatment n (%)	15 (22)
Induction immunosuppression n (%)
Monoclonal antibodies	10 (14)
Steroids	49 (72)
Other	3 (4)
NA	6 (10)
Maintenance immunosuppression n (%)
Cyclosporine	30 (44)
Tacrolimus	22 (32)
Cyclosporine + steroids	6 (9)
Tacrolimus + steroids	9 (13)
Other	1 (1.5)

LT: Liver transplantation; OLT: Orthotopic liver transplantation; CMV: Cytomegalovirus.

Table 2 Characteristics of patients developing neutropenia

	G-CSF	No G-CSF	P
Sex (M/F)	10/13	Dec-33	NS
Age, median (range)	60 (41-68)	58 (22-67)	NS
Months since LT, median (range)	15 (2-151)	19 (1-148)
Genotype n (%)
1	17 (73)	36 (80)	NS
2	2 (8.6)	4 (8.8)	NS
3	2 (8.6)	2 (4.4)	NS
4	2 (8.6)	3 (6.6)	NS
Neutrophil count (× 103/mmc) mean ± SD	2.23 ± 0.96	3.14 ± 1.22	0.0021
Cirrhosis n (%)	10 (15)
Induction immunosuppression n (%)
Monoclonal antibodies	4 (17)	6 (13)	NS
Steroids	17 (73)	32 (71)	NS
Other	1 (3)	2 (4)	NS
NA	1 (3)	5 (1)	NS
Maintenance immunosuppression n (%)
Cyclosporine	10 (43)	20 (44)	NS
Tacrolimus	8 (34)	14 (31)	NS
Cyclosporine + steroids	1 (4)	5 (11)	NS
Tacrolimus + steroids	3 (13)	6 (13)	NS
Other	1 (4)	0	NS

G-CSF: Granulocyte colony stimulating factors.

Table 3 Peg-IFN and RBV dose reductions n (%)

	G-CSF	No G-CSF	P
RBV reduction	6 (26)	17 (37)	0.4
RBV withdrawal	4 (17)	3 (6)	0.2
Peg-IFN + RBV reduction	2 (8)	1 (2)	0.2

Peg-IFN: Pegylated interferons; RBV: Ribavirin.

Table 4 Causes of premature discontinuation in the two groups

Discontinuation cause	G-CSF group	Non neutropenic group
Liver decompensation	3	3
Severe asthenia	2	1
Neutropenia	1
Anemia	1
Toxic hepatitis	1
Non response		1
Liver abscess		1
De novo AIH		9
De novo HBV infection		1

AIH: Autoimmune hepatitis; HBV: Hepatitis B virus.