Reactions 1423 - 13 Oct 2012

SInterferon-α/thalidomide

Neutropenia: case reportA 56-year-old woman developed neutropenia while

receiving interferon-α for the treatment of hereditaryhaemorrhagic teleangiectasis. She subsequently developedneutropenia during treatment with thalidomide [Myrin].

The woman had hypochromic anaemia and had beenexperiencing recurrent nose bleeds since the age of35 years. In 2011, she began first-line therapy withinterferon-α at a dosage of 1.5 million units 3 times perweek. During the first 3 injections, she developedpronounced myelosuppression with significantly reducedneutrophil and platelet counts. Bone marrow examinationrevealed a significant iron deficit, with only 4% sideroblasts.A biopsy showed depression of granulopoiesis with anabsence of dyeable stromal iron.

Interferon-α was discontinued, and the woman receivederythrocyte transfusions. She started receiving thalidomide100mg daily. One month later, she developed neutropenia,and the dosage of thalidomide was decreased to 100mgevery second day [outcome not stated].

Author comment: This patient experienced changes inwhite blood cell count, neutrophil granulocytes andthrombocytes during the first few days of treatment byinterferon at a dosage of 1.5 million units three times a week.Unusually great reduction resulted in discontinuation ofinterferon-α after 3 injections.Adam Z, et al. Teleangiectasia hereditaria haemorrhagica - Osler-Weber-Rendusyndrome. Case study and treatment experience. Vnitrni lekarstvi 58: 477-489, No.6, Jan 2012 [Czech; summarised from a translation] - Czech Republic 803078380

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Reactions 13 Oct 2012 No. 14230114-9954/10/1423-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved