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Hairy cell leukemia
Author(s) -
Zinzani Pier Luigi,
Pellegrini Cinzia,
Stefoni Vittorio,
Derenzini Enrico,
Gandolfi Letizia,
Broccoli Alessandro,
Argnani Lisa,
Quirini Federica,
Pileri Stefano,
Baccarani Michele
Publication year - 2010
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.25243
Subject(s) - medicine , gastroenterology , pentostatin , complete response , hairy cell leukemia , surgery , cladribine , leukemia , lymphoma , rituximab , chemotherapy
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. Cancer 2010. © 2010 American Cancer Society.