BACKGROUND: Historically, the first treatment choices for hairy cell leukemia (HCL) were splenectomy and alpha-interferon. Recently, purine analogues (pentostatin and cladribine) changed radically the treatment modality, inducing complete and durable responses in the majority of patients. METHODS: The authors analyzed the outcome of different lines of therapy in 121 HCL patients followed in their institute from 1986 to 2008, with a median follow-up of 105 months. Patients were divided into subgroups according to the number of treatments; Group A included 121 patients who underwent a front-line therapy, Group B patients (n =53) were treated with 2 lines, Group C patients (n = 34) with 3 lines, Group D patients (n = 17) with 4 lines, and Group E patients (n = 8) with 5 lines. RESULTS: In Group A, 92 (77%) patients obtained a complete response (CR), 23 (18%) a partial response, and the remaining 6 (5%) a minor or no response; median duration of response was 2.7 years. In Group B, 53 relapsed patients achieved a second CR rate of 73.5%; median duration of response was 2.5 years. Group C contained 34 patients in a second relapse, with a CR rate after the third line of treatment of 70.5% (median duration of response, 2.2 years). In Group D, 11 (64.7%) patients obtained a CR (median duration of response, 1.6 years), and in Group E 4 (50%) of 8 patients achieved a CR (median duration of response, 1.3 years). CONCLUSIONS: This study confirms the high risk (>40% of all patients) of retreatment of HCL patients and the need to maximize primary response.
BACKGROUND: Historically, the first treatment choices for hairy cell leukemia (HCL) were splenectomy and alpha-interferon. Recently, purine analogues (pentostatin and cladribine) changed radically the treatment modality, inducing complete and durable responses in the majority of patients. METHODS: The authors analyzed the outcome of different lines of therapy in 121 HCL patients followed in their institute from 1986 to 2008, with a median follow-up of 105 months. Patients were divided into subgroups according to the number of treatments; Group A included 121 patients who underwent a front-line therapy, Group B patients (n =53) were treated with 2 lines, Group C patients (n = 34) with 3 lines, Group D patients (n = 17) with 4 lines, and Group E patients (n = 8) with 5 lines. RESULTS: In Group A, 92 (77%) patients obtained a complete response (CR), 23 (18%) a partial response, and the remaining 6 (5%) a minor or no response; median duration of response was 2.7 years. In Group B, 53 relapsed patients achieved a second CR rate of 73.5%; median duration of response was 2.5 years. Group C contained 34 patients in a second relapse, with a CR rate after the third line of treatment of 70.5% (median duration of response, 2.2 years). In Group D, 11 (64.7%) patients obtained a CR (median duration of response, 1.6 years), and in Group E 4 (50%) of 8 patients achieved a CR (median duration of response, 1.3 years). CONCLUSIONS: This study confirms the high risk (>40% of all patients) of retreatment of HCL patients and the need to maximize primary response.
Authors: Leslie A Andritsos; Neil Dunavin; Gerard Lozanski; Jeffrey A Jones; James S Blachly; David M Lucas; John C Byrd; Eric Kraut; Michael R Grever Journal: Haematologica Date: 2014-10-31 Impact factor: 9.941
Authors: Michael R Grever; Omar Abdel-Wahab; Leslie A Andritsos; Versha Banerji; Jacqueline Barrientos; James S Blachly; Timothy G Call; Daniel Catovsky; Claire Dearden; Judit Demeter; Monica Else; Francesco Forconi; Alessandro Gozzetti; Anthony D Ho; James B Johnston; Jeffrey Jones; Gunnar Juliusson; Eric Kraut; Robert J Kreitman; Loree Larratt; Francesco Lauria; Gerard Lozanski; Emili Montserrat; Sameer A Parikh; Jae H Park; Aaron Polliack; Graeme R Quest; Kanti R Rai; Farhad Ravandi; Tadeusz Robak; Alan Saven; John F Seymour; Tamar Tadmor; Martin S Tallman; Constantine Tam; Enrico Tiacci; Xavier Troussard; Clive S Zent; Thorsten Zenz; Pier Luigi Zinzani; Brunangelo Falini Journal: Blood Date: 2016-11-30 Impact factor: 22.113