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

Expert Opin Drug Saf. 2010 Nov;9(6):875-81. doi: 10.1517/14740338.2010.510831.

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.

MeSH terms

  • 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
  • Interferon-alpha / therapeutic use*
  • Male
  • Middle Aged
  • Neutropenia / chemically induced*
  • Polyethylene Glycols / adverse effects
  • Polyethylene Glycols / therapeutic use*
  • Pyridones / adverse effects*
  • Recombinant Proteins
  • Retrospective Studies
  • Siderophores / therapeutic use*
  • beta-Thalassemia / drug therapy

Substances

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