Long‐term follow‐up of interferon‐alpha induction and low‐dose maintenance therapy in hairy cell leukemia

Benz, Rudolf; Siciliano, Raffaele Daniele; Stüssi, Georg; Fehr, Jörg

doi:10.1111/j.1600-0609.2008.01190.x

Cited by 28 publications

(24 citation statements)

References 30 publications

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“…[43][44][45] However, with the advent of purine analogues, the role of interferon-alfa as initial treatment for HCL is very limited. It may, however, be useful for the management of relapsed or refractory (R/R) disease.…”

Section: Treatment Options Initial Treatmentmentioning

confidence: 99%

Hairy Cell Leukemia, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Wierda

Byrd

Abramson

et al. 2017

J Natl Compr Canc Netw

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Section: Treatment Options Initial Treatmentmentioning

confidence: 99%

Hairy Cell Leukemia, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Wierda

Byrd

Abramson

et al. 2017

J Natl Compr Canc Netw

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“…Benz et al recently updated the experience of low-dose interferon with maintenance. 63 They suggest that there may be a role for this useful drug in specific patients, considering the lingering concern over secondary malignancies associated with the purine analogs; in addition, there may be an opportunity for this agent to help those too frail to receive a purine analog-based regimen. 63 …”

Section: How To Treat: Summary Of Standard Therapeutic Approachesmentioning

confidence: 99%

How I treat hairy cell leukemia

Grever

2010

Blood

141

124

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The description of hairy cell leukemia as a specific clinical entity was published 50 years ago. The clinical outcome for patients was hampered by ineffective chemotherapy, and splenectomy was the major therapeutic approach to improve peripheral blood counts. The median survival after diagnosis was 4 years. With the introduction of ␣-interferon in 1984, marked improvements in patient responses were observed. Shortly thereafter, the introduction of the purine nucleoside analogs transformed this disease into a highly treatable form of leukemia, and patients with the classic form of this rare leukemia now have a near-normal life expectancy. However, other clinical entities mimicking this disease do not respond; thus, accurate diagnosis is important. Immunophenotypic features in classic hairy cell leukemia show that the leukemic cells express CD11c, CD25, CD103, and CD123 and display bright CD20. Despite the high percentage of durable complete remissions with modern therapy, the long-term disease-free survival curves have not reached a plateau. Many patients who achieve a complete remission by morphologic criteria have minimal residual disease demonstrable by either flow cytometry or immunohistochemical staining, and this population may be at higher risk for earlier relapse. Continued clinical research is essential to optimize therapy for this disease. (Blood. 2010;115:21-28) IntroductionIn 1958, Bouroncle et al described a series of patients with leukemic reticuloendotheliosis. 1 Although this collection of cases established that the previously described isolated reports actually represented a distinct hematologic malignancy, the classic manuscript contained a very thorough presentation of the many clinical facets of this disease now known as hairy cell leukemia (HCL). Furthermore, it established that therapeutic intervention was limited either to careful titration of alkylating agents or to splenectomy. The ability to alter the clinical course of the patients with this rare form of leukemia did not substantially change until the introduction of ␣-interferon in 1984. 2 Shortly thereafter, observations that a purine nucleoside analog (pentostatin) could induce a high degree of complete remissions (eg, 75%-89%) in this previously "untreatable" chronic leukemia changed the natural history of HCL in record time. [3][4][5][6][7][8] Another purine nucleoside analog (cladribine) produced remarkably high remission rates (eg, 91%) with a single course of therapy. 9,10 The outstanding results with this agent delivered as a single course of therapy led to cladribine being the initial therapy selected by most hematologists. Many of the initial studies with this agent excluded patients with active infection from enrollment, but studies from multiple institutions confirmed the high complete remission rate with this drug. [11][12][13][14] Thus, patients who are treated with either purine nucleoside analog as front-line therapy will achieve a high rate of complete remission (75%-90%). 7,10 The long-term studies reported at 5 to 10...

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“…Our case raises the question of first-line treatment for HCL preceding by severe viral infection. It was proved that 2-CdA administered daily or weekly has similar toxicity profile [12], but interferon alpha seems to have better safety profile [18]. In retrospect, we would recommend treatment delay in this particular case, the more the blood results were stable.…”

Section: Discussionmentioning

confidence: 90%

Irreversible marrow aplasia after single course of 2-chlorodeoxyadenosine for hairy cell leukaemia preceding by A pandemic 2009-H1N1-associated pneumonia

et al. 2010

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Hairy cell leukaemia (HCL) is a rare, indolent lymphoproliferative disorder characterized by varying degrees of cytopenias and the presence of malignant B cells with cytoplasmic projections. Cladribine (2-chlorodeoxyadenosine, 2-CdA) is an adenosine deaminase-resistant purine analogue and has been shown to be very effective as a first-line therapeutic option for HCL. The therapy with 2-CdA is found to be well tolerated with a paucity of toxicity. The common side effects include immunosuppression and reversible myelosuppression. We report a HCL patient with A pandemic 2009-H1N1-associated pneumonia who fully recovered after oseltamivir and antibiotics. The subsequent treatment with single 5-day course of 2-CdA resulted in persistent marrow aplasia with fatal systemic aspergillosis.

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Long‐term follow‐up of interferon‐alpha induction and low‐dose maintenance therapy in hairy cell leukemia

Cited by 28 publications

References 30 publications

Hairy Cell Leukemia, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Hairy Cell Leukemia, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

How I treat hairy cell leukemia

Irreversible marrow aplasia after single course of 2-chlorodeoxyadenosine for hairy cell leukaemia preceding by A pandemic 2009-H1N1-associated pneumonia

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