Secondary T-lymphoblastic leukemia in a patient with hairy cell leukemia following cladribine therapy: report of an extremely rare case and review of the literature

Setoodeh, Reza; Zhang, Ling

doi:10.3109/10428194.2011.628722

Cited by 5 publications

(4 citation statements)

References 12 publications

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“…The overall mortality was 8.8% (43/489) in the whole non-cancer population and 25% (6/24) among the patients with second cancers: as expected, the median OS was markedly worse among these 24 patients. Although no t-MNs were diagnosed in our population, different reports of acute and chronic leukemia have been published, including a patient who underwent successful allogeneic stem cell transplantation [20,[22][23][24][25][26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Second Neoplasms in Italian Patients with Hairy Cell Leukemia after Treatment with Cladribine: A Multicenter Investigation and Literature Review

Criscuolo,

Tosti,

Broccoli

et al. 2024

Cancers

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Concern has emerged about the prevalence of second cancers among patients with hairy cell leukemia (HCL) treated with purine analogs. We investigated 513 patients with HCL treated with cladribine over the last 30 years at 18 Italian centers and calculated their standardized incidence ratios (SIRs). We identified 24 patients with a second cancer diagnosed at a median time from treatment with cladribine of 59.9 months (range: 9.2–169.7 months). All patients with solid neoplasms presented with a limited-stage disease, except four cases of locally advanced cancer; multiple myeloma patients had a smoldering disease, while lymphoma patients had stage Ie and stage IV diseases. Response to therapy was complete in 19 cases; 1 patient is still receiving treatment for a relapsing bladder disease, while 2 patients progressed during treatment and died. These two patients died from unrelated causes: one from infection and one due to surgery complications. The median OS from HCL was 98.5 months (range: 38.4–409.2 months), while the median OS from second cancer was 27.6 months (range: 1–117.8 months). The SIR was 0.86 (95% CI: 0.54–1.30) for males and 1.13 (95% CI: 0.36–2.73) for females: no statistically significant differences were highlighted. We were not able to demonstrate an excess of second cancer or a significant association with the specific studied neoplasm.

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Section: Discussionmentioning

confidence: 99%

Second Neoplasms in Italian Patients with Hairy Cell Leukemia after Treatment with Cladribine: A Multicenter Investigation and Literature Review

Criscuolo,

Tosti,

Broccoli

et al. 2024

Cancers

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show abstract

“…By contrast, its use in other indolent lymphomas is relatively rare in spite of solid response rates [14,15]. This is probably not only because of high acute toxicity with grade III/IV neutropenia in more than 80% of treated HCL patients [12] but also because of reports on increased hematological long-term toxicities including prolonged pancytopenia and leukemia development, respectively [12,19,20,[22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…Prolonged hematotoxicity, MDS, and development of acute leukemia following cladribine treatment have been reported in the literature, but the data are based mostly on small series . In addition, some HCL studies have reported on the occurrence of prolonged pancytopenia with a recovery time to normal blood counts of up to 100 days after application of cladribine .…”

Section: Discussionmentioning

confidence: 99%

“…However, other studies using cladribine have reported the potential for severe acute hematological toxicity and prolonged pancytopenia [12,[19][20][21]. In addition, an increased risk of myelodysplastic syndromes (MDSs) and leukemia has been suggested, which might be a caveat for use in a mostly asymptomatic patient population with a median survival of more than 10 years [19,[22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

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Long‐term safety and activity of cladribine in patients with extranodal B‐cell marginal zone lymphoma of the mucosa‐associated lymphoid tissue (MALT) lymphoma

Kiesewetter

Dolak

Simonitsch‐Klupp

et al. 2015

Hematological Oncology

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The purine analogue 2-chloro-deoxyadenosine (2-CDA, cladribine) +/- rituximab has been successfully tested in mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) patients. However, studies using cladribine in other indications have reported the potential for prolonged hematological side effects and secondary hematologic and non-hematologic malignancies. To date, there have been no data on long-term effects of cladribine in MALT lymphoma patients. We have analyzed a large number of 49 patients treated with cladribine at our institution 1997-2011. All patients were treated within clinical trials and had undergone a standardized follow-up protocol minimizing a potential bias in the detection of late sequels and relapses. After a median follow-up time of 61 months (interquartile range: 43-72) for 49 analyzed patients, 35 (71%) are alive, while 14 (29%) have died. In the entire collective, three cases (6%) of prolonged pancytopenia including manifest myelodysplastic syndrome in one patient (2%), three cases (6%) of secondary lymphoid malignancies, and five cases (10%) of non-hematologic cancers were documented. In terms of outcome, 42/49 (86%) patients responded to cladribine-containing treatment, and only 10/42 (24%) responding patients needed further treatment after a median time to progression of 14 months (interquartile range, 8-34). Currently, 25/35 (71%) patients being alive are in ongoing complete remission and 2/35 (6%) in ongoing stable disease, respectively. Eight patients (23%) are free of lymphoma after second-line therapy, with the median overall survival not having been reached. Our data suggest that cladribine might be safely applied in patients with MALT lymphoma, also in terms of long-term toxicities. These data also confirm the potential of cladribine to induce durable remissions. Copyright © 2015 John Wiley & Sons, Ltd.

Secondary T-lymphoblastic leukemia in a patient with hairy cell leukemia following cladribine therapy: report of an extremely rare case and review of the literature

Cited by 5 publications

References 12 publications

Second Neoplasms in Italian Patients with Hairy Cell Leukemia after Treatment with Cladribine: A Multicenter Investigation and Literature Review

Second Neoplasms in Italian Patients with Hairy Cell Leukemia after Treatment with Cladribine: A Multicenter Investigation and Literature Review

Long‐term safety and activity of cladribine in patients with extranodal B‐cell marginal zone lymphoma of the mucosa‐associated lymphoid tissue (MALT) lymphoma

First reports of serious adverse drug reactions in recent weeks

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