The therapeutic effect of leucogen in treating alcoholic liver cirrhosis with thrombocytopenia or leukopenia.

Annals of Saudi medicine Pub Date : 2025-01-01 Epub Date: 2025-02-06 DOI:10.5144/0256-4947.2025.9
Min Su, Mengwen He, Wu-Cai Yang, Jianjun Wang, Chang Guo, Yi-Ming Fu, Chun-Wang, Shuyao Li, Dong Ji, Hong-Yan Chen
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Abstract

Background: Thrombocytopenia and leukopenia are common complications of alcoholic liver cirrhosis (ALC) and are associated with an increased risk of bleeding, infection and mortality.

Objectives: Evaluate the effectiveness and safety of leucogen, a cysteine derivative that increases platelet (PLT) and white blood cell (WBC) counts in ALC patients.

Design: Retrospective.

Setting: Department of hepatology, general hospital.

Patients and methods: Patients with ALC who had thrombocytopenia and/or leukopenia were enrolled between 2022 and 2023 and were divided into two groups based on their treatment: the leucogen group (20 mg, three times per day) and the non-leucogen group.

Main outcome measures: The primary endpoint was an increase in PLT or WBC of ≥5% from baseline.

Sample size: 413 patients (320 patients in the final analysis).

Results: In this retrospective study, 320 patients were analyzed post-propensity score matching: 160 patients each in the leucogen and non-leucogen groups. Following 3 months of treatment, the leucogen group experienced a median increase in PLT levels of 1.0×109/L versus a decrease of 3.0×109/L in the non-leucogen group (P=.003), and a median increase in WBC counts of 0.1×109/L compared to a decrease of 0.1×109/L (P=.006). The changes in ALT, AST, and TBIL levels were not significantly different between groups. A higher proportion of patients in the leucogen group experienced increases in both PLT (46.9% vs. 32.5%, P=.012) and WBC counts (50.0% vs. 36.2%, P=.018), and 28.1% of patients in the leucogen group had increases in both parameters, compared to 15.6% in the non-leucogen group (P=.01). The leucogen group also demonstrated greater increases in PLT (OR 1.833; P=.009) and WBC counts (OR 1.759; P=.013) compared to the non-leucogen group. The safety profile of leucogen was favorable, with no significant adverse events reported. Leucogen was particularly beneficial for patients younger than 60 years and those with lower baseline ALT and AST levels, showing significant improvements in both PLT and WBC counts in these subgroups.

Conclusions: Leucogen effectively increased PLT and WBC counts in patients with ALC, showing a favorable safety profile.

Limitations: Retrospective study.

白细胞原治疗酒精性肝硬化伴血小板减少或白细胞减少的疗效观察。
背景:血小板减少和白细胞减少是酒精性肝硬化(ALC)的常见并发症,并与出血、感染和死亡风险增加相关。目的:评估白细胞原的有效性和安全性,白细胞原是一种半胱氨酸衍生物,可增加ALC患者的血小板(PLT)和白细胞(WBC)计数。设计:回顾性。单位:综合医院肝脏内科。患者和方法:在2022年至2023年期间招募患有血小板减少和/或白细胞减少的ALC患者,并根据治疗分为两组:白细胞组(20mg,每天3次)和非白细胞组。主要结局指标:主要终点是PLT或WBC较基线增加≥5%。样本量:413例(最终分析320例)。结果:在这项回顾性研究中,对320例患者进行了倾向评分匹配分析:白细胞组和非白细胞组各160例。治疗3个月后,白细胞素组PLT水平中位数升高1.0×109/L,而非白细胞素组降低3.0×109/L (P= 0.003),白细胞计数中位数升高0.1×109/L,而降低0.1×109/L (P= 0.006)。各组间ALT、AST、TBIL水平变化无显著性差异。白细胞组中较高比例的患者PLT(46.9%比32.5%,P= 0.012)和白细胞计数(50.0%比36.2%,P= 0.018)均升高,白细胞组中28.1%的患者两项参数均升高,而非白细胞组中这一比例为15.6% (P= 0.01)。亮素组PLT也有较大的增加(OR为1.833;P= 0.009)和白细胞计数(OR 1.759;P= 0.013)。白细胞原的安全性是良好的,没有明显的不良事件报道。对于年龄小于60岁的患者以及ALT和AST基线水平较低的患者,亮素尤其有益,在这些亚组中显示出PLT和WBC计数的显著改善。结论:白细胞原可有效增加ALC患者的PLT和WBC计数,显示出良好的安全性。局限性:回顾性研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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