Potential breakthroughs with investigational drugs for hairy cell leukemia

Robak, Tadeusz; Wolska, Anna; Robak, Paweł

doi:10.1517/13543784.2015.1081895

Cited by 12 publications

(9 citation statements)

References 89 publications

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“…However, due to the prolonged recovery phase of osseous abnormalities, MRI may give a false‐positive result in the treatment evaluation and follow‐up. Some studies indicate that 18 F‐FDG PET/CT can be a useful imaging method for staging and treatment evaluation in HCL 27,39‐42 . PET indicates bone metabolic activity for uptake and deliver useful functional information, especially for patients with subtle abnormalities (Figure 3).…”

Section: Resultsmentioning

confidence: 99%

“…Some studies indicate that 18 F-FDG PET/CT can be a useful imaging method for staging and treatment evaluation in HCL. 27,[39][40][41][42] PET indicates bone metabolic activity for uptake and deliver useful functional information, especially for patients with subtle abnormalities (Figure 3). 32 Importantly, PET is more specific and sensitive than MRI and other imaging methods and can detect bone disease earlier.…”

Section: Imaging Modalities In Diagnosis and Monitoringmentioning

confidence: 99%

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Bone lesions in hairy cell leukemia: Diagnosis and treatment

Robak

Jesionek-Kupnicka

Kupnicki

et al. 2020

European J of Haematology

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Hairy cell leukemia (HCL) is a rare and indolent form of small mature B-cell leukemias. The annual incidence of HCL is estimated to be 0.3 cases per 100 000, and the disease comprises 2%-3% of all leukemias. 1,2 It was estimated that 1100 new cases of HCL and 4060 deaths occurred in 2016 in the USA. 3,4 It is mostly a disease of middle-aged males (median age 55 years and 4:1 male predominance). Patients present most frequently with splenomegaly, pancytopenia, and bone marrow infiltration. Hairy cells characteristically stain strongly positive for tartrate-resistant acid phosphatase (TRAP) and have a typical pattern of B-cell antigen expression (CD19, CD20) with co-expression of CD11c, CD25, and CD103. Cell surface markers associated with normal B-cell activation, especially CD22, CD72, and CD40, are also strongly expressed. 3,4 The BRAF V600E mutation is present in all patients and is regarded as a disease-defining genetic event. 5 Purine nucleoside analogs (PNA), cladribine (2-CDA), and pentostatin (DCF, deoxycoformycin) are the drugs of choice in first-line treatment of HCL 3,4 ; they induce durable and unmaintained complete response (CR) in more than 70% of patients, with relapse rates of 30%-40%, after 5-to 10-year follow-up. However, despite very high initial response rates, many patients ultimately relapse or develop refractory disease and will require novel therapies after these agents. 3 Unusual clinical manifestations of HCL are occasionally reported. 6-14 These rare symptoms may include bulky abdominal lymphadenopathy, tumor masses in the mediastinum, paravertebral masses,

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Section: Resultsmentioning

confidence: 99%

Section: Imaging Modalities In Diagnosis and Monitoringmentioning

confidence: 99%

Bone lesions in hairy cell leukemia: Diagnosis and treatment

Robak

Jesionek-Kupnicka

Kupnicki

et al. 2020

European J of Haematology

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“…However, these studies have included few patients, and the long-term results are unknown. 13 The recent approval of moxetumomab pasudotox (Lumoxiti Õ ) represents an important advance in the treatment of relapsed HCL. It was approved for the treatment of adult patients with relapsed or refractory HCL who have received at least two prior systemic therapies, including treatment with a purine analog.…”

Section: Treatment Of Relapsed Diseasementioning

confidence: 99%

“…1,2,4,12 There are no randomized studies comparing the two purine analogues due to the rarity of the disease; however, most references report equal efficacy. [2][3][4][5]12,13 The most common adverse effect of cladribine is neutropenic fever, while myelosuppression and renal toxicity are frequently reported with pentostatin therapy. 3,14 Both agents are known to cause prolonged and profound T-cell depletion, and this may contribute to the greater incidence of secondary malignancies observed in patients with HCL.…”

Section: Introductionmentioning

confidence: 99%

Moxetumomab pasudotox: A first-in-class treatment for hairy cell leukemia

Fancher

Lally-Montgomery

2019

J Oncol Pharm Pract

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Hairy cell leukemia is a rare indolent B-cell lymphoid malignancy. Durable remission can be obtained with purine analogues, but relapse is inevitable, and effective treatment options may be limited. Moxetumomab pasudotox is a recombinant CD22-targeting immunotoxin that has recently been approved by the United States Food and Drug Administration for the treatment of relapsed or refractory hairy cell leukemia. Approval was based on a pivotal phase III study in this unique patient population. Rationale for use, clinical trial data, and current treatment recommendations are detailed. Common adverse effects are reviewed, and management strategies for select adverse effects are suggested. Implications for contemporary practitioners are also provided, as use of this novel agent is likely to increase as follow-up studies are reported.

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“…Better results were observed when rituximab was combined with cladribine [19]. Recently, anti-CD22 immunotoxin moxetumomab pasudotox (Lumoxiti, Astra Zeneca) has been approved by the FDA for the treatment of relapsed or refractory HCL patients who have received at least two prior systemic therapies, including a purine nucleoside analog [20,21]. The oral BRAF inhibitor vemurafenib (Zelboraf™, Roche) has been also shown to have antitumor activity in BRAF V600-mutated HCL [22].…”

Section: Introductionmentioning

confidence: 99%

Skin changes in hairy cell leukemia

2020

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Skin lesions have been reported in about 10–12% of hairy cell leukemia (HCL) patients. Most are etiologically related to autoimmune or infectious processes, although secondary cutaneous neoplasms and drug-induced lesions are also reported. However, leukemia cutis with the direct infiltration of the skin by leukemic cells is extremely rare in HCL patients. This paper reviews the epidemiology, pathogenesis, clinical symptoms, diagnosis, and approach to treating skin lesions in HCL. A literature review of the MEDLINE database for articles in English concerning hairy cell leukemia, skin lesions, leukemia cutis, adverse events, infectious, cutaneous, drug reactions, neutrophilic dermatoses, secondary neoplasms, and vasculitis was conducted via PubMed. Publications from January 1980 to September 2020 were scrutinized. Additional relevant publications were obtained by reviewing the references from the chosen articles.

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Potential breakthroughs with investigational drugs for hairy cell leukemia

Abstract: The use of vemurafenib and moxetumomab pasudotox is a promising new strategy for the treatment of HCL. Data from ongoing and future clinical trials will aid in better defining the status of new drugs in the treatment of HCL.

Cited by 12 publications

References 89 publications

Bone lesions in hairy cell leukemia: Diagnosis and treatment

Bone lesions in hairy cell leukemia: Diagnosis and treatment

Moxetumomab pasudotox: A first-in-class treatment for hairy cell leukemia

Skin changes in hairy cell leukemia

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