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

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 1.0×10
9
/L versus a decrease of 3.0×10
9
/L in the non-leucogen group (
P
=.003), and a median increase in WBC counts of 0.1×10
9
/L compared to a decrease of 0.1×10
9
/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