Copyright
©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 7, 2015; 21(17): 5421-5426
Published online May 7, 2015. doi: 10.3748/wjg.v21.i17.5421
Published online May 7, 2015. doi: 10.3748/wjg.v21.i17.5421
Aplastic anemia and severe pancytopenia during treatment with peg-interferon, ribavirin and telaprevir for chronic hepatitis C
Sabela Lens, Zoe Mariño, María-Carlota Londoño, Jose M Sánchez-Tapias, Xavier Forns, Liver Unit, Hospital Clinic, IDIBAPS, CIBERehd, 08036 Barcelona, Spain
Jose L Calleja, Christie Perello, Juan de la Revilla, Liver Unit, Hospital Puerta del Hierro, IDIPHIM, CIBERehd, 28222 Majadahonda, Madrid, Spain
Ana Campillo, Gastroenterology Department, Hospital Reina Sofia, 31500 Tudela, Navarra, Spain
Jose A Carrión, Teresa Broquetas, Liver Unit, Hospital Del Mar, IMIM, CIBERehd, 08003 Barcelona, Spain
Álvaro Urbano-Ispizua, Hematology Unit, Hospital Clinic, 08036 Barcelona, Spain
Author contributions: All authors contributed equally to this manuscript.
Supported by (in part) Instituto de Salud Carlos III (PI11/01907), Ministerio de Economía y Competitividad, co-funded by Fondo Europeo de Desarrollo Regional, Unión Europea, Una manera de hacer Europa; and Roche Organ Transplantation Research Foundation (ROTRF, CI: 442035057) (all to Forns X).
Ethics approval: The study was reviewed and approved by the Hospital Clínic Institutional Review Board.
Informed consent: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest: The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sabela Lens, MD, Liver Unit, Hospital Clinic, IDIBAPS, CIBERehd, C/Villarroel 170, 08036 Barcelona, Spain. slens@clinic.ub.es
Telephone: +34-93-2275400
Received: October 30, 2014
Peer-review started: October 30, 2014
First decision: November 14, 2014
Revised: December 20, 2014
Accepted: February 11, 2015
Article in press: February 11, 2015
Published online: May 7, 2015
Peer-review started: October 30, 2014
First decision: November 14, 2014
Revised: December 20, 2014
Accepted: February 11, 2015
Article in press: February 11, 2015
Published online: May 7, 2015
Core Tip
Core tip: Addition of the new directly acting antivirals, Telaprevir and Boceprevir, clearly improved sustained virological response rates in patients with chronic hepatitis C. However, these combinations have also increased the risk of serious adverse events, especially in patients with advanced liver fibrosis. We describe the development of severe pancytopenia and aplastic anemia during triple therapy with telaprevir in patients with advanced liver disease (before or after liver transplantation). Close monitoring is imperative in this setting to promptly detect serious hematological disorders and to prevent further complications.