Kronik hepatit b hastalarında mono/kombine tedavi süresince hematolojik yan etkilerin değerlendirilmesi

Amaç: Bu çalışma, kronik hepatit B (KHB) hastalarında mono/kombine tedavi şeklinde uygulanan pegileinterferon ve pegileinterferon+lamivudin tedavisi süresince ortaya çıkan hematolojik yan etkilerin araştırılması amacıyla yapıldı. Gereç ve Yöntem: Çalışmada KHB tanısı alan toplam 54 hasta dört tedavi grubuna ayrıldı: Grup 1’deki hastalara pegileinterferon-alfa 2a; grup 2’ye pegileinterferon-alfa 2a ve lamivudin; grup 3’e pegileinterferon-alfa 2b ve grup 4’e pegileinterferon-alfa 2b ve lamivudin tedavisi uygulandı. Hastalar tedavinin 12, 24 ve 48. haftalarında ortaya çıkan hematolojik yan etkiler (anemi, trombositopeni, lökopeni ve nötropeni), açısından değerlendirildi. Bulgular: Anemi ve lökopeni sıklığı değerlendirildiğinde gruplar arasında tedavinin 12, 24 ve 48. haftalardaki takiplerinde istatistiksel anlamlı farklılık saptanmadı. Trombositopeni sıklığı açısından 12. haftadaki takipler de gruplar arasında anlamlı farklılık saptanmazken, 24 ve 48. haftada trombositopeni sıklığı grup 2’de ile grup 1’de arasında, grup 2’de daha yüksek olarak istatistiksel anlamlı farklılık saptandı. Buna karşın 24 ve 48. haftada diğer gruplar arasında trombositopeni açısından farklılık görülmedi. Nötropeni sıklığı ise 12, 24 ve 48. haftalardaki değerlendirmeler de grup 2 ile grup 3 arasında, grup 2’de daha yüksek olmak üzere istatistiksel açıdan farklı idi. Diğer gruplar arasında arasında trombositopeni ve nötropeni oranlarında istatistiksel anlamlı farklılık saptanmadı. Sonuç: Kombine tedavi alan gruplar arasında istatistiksel olarak anlamlı bir fark olmamasına rağmen monoterapi grubuna kıyasla hematolojik yan etki oranları daha yüksekti. Bu gruplarda interferon ve lamivudinin hematopoetik sisteme tek başlarına olduğundan daha toksik olduğunu saptadık. Bu konuda vaka sayısının daha fazla olduğu ileriki çalışmalara ihtiyaç vardır.

The evaluation of hematologic side effects during mono/combinetherapy in chronic hepatitis b patients

Objective : In this study, we aimed to search the occurrence of hematologic side effect during monotherapy or combinetherapy of pegyleinterferon and pegyleinterferon + lamivudin treatment in choronic hepatitis B (CHB) patients. Materyal and Methods: In this study, a total of 54 patients with a diagnosis of CHB were grouped into four treatment groups: Patients in Group 1 received pegylated interferon-alpha 2a; patients in Group 2 received pegylated interferon-alpha 2a + lamivudine; patients in Group 3 received pegylated interferon-alpha 2b, and patients in Group 4 received pegylated interferon-alpha 2b + lamivudine treatment. Patients were examined for hematologic side effects at the 12th, 24th, and 48th weeks of treatment. Results: There was no statistically significant difference among groups in the frequency of anemia and leucopenia during 12th, 24th, and 48th weeks of treatment. There was also no statistically significant difference among groups in the frequency of trombocytopenia in 12th weeks treatment. On the other hard, there was statistically significant difference between group 1 and 2 (group 2 had higher results ) in the frequency of trombocytopenia. Besides, the frequency of neutropenia was statistically different between group 2 and 3 (group 2 had higher results). There was no statistically difference among other groups in the frequency of trombocytopenia and neutropenia. Conclusion: There was no statistically significant difference among groups having combinetherapy however they had higher rates of hematologic side effects, compared to monotherapy groups. In the groups, interferon and lamivudin combinetherapy was toxic to hematologic system, compoted to their monotherapia. More studies need to be done to support our conclusion.

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