Results of Cladribine in Hairy Cell Leukemia: Nasser Institute Experience.
Haitham Elsayd Sherif;
Abstract
Hairy cell leukemia (HCL) is a rare chronic lymphoproliferative disorder. Till 1980 splenectomy was the best line of treatment. The first effective drug in the treatment of the disease was interferon alpha, then pentostatin had a role in treating this disease.But now cladribine (2cda) gave a complete remission rate ranging from 75%-90% .
AIM &METHODS:
In the current study thirty three patients with hairy cell leukemia presented to the Hematology Department at Nasser Institute hospital in the period from January 2000 to June 2010. The male to female ratio was 3.7:1 with a mean age of 44.5 years (29-67); one of these patients underwent splenectomy before therapy. Splenomegaly was found in 32/33 (96.9%), while one patient showed no initial splenomegaly. The mean TLC, hemoglobin, and platelet counts before treatment were 2.8x10/L, 8.8 gm/dl, and 61.000 /mm3 respectively, 93.9% of our patients (31/33) showed infiltration by hairy cells in their bone marrow aspirate .TRAP test was positive in 30 out of 33 patients (90.9%).Immunophenotyping of the bone marrow aspirate revealed CD 103 and CD 25 positivity in 84.8 % and 63.6% of our patients respectively.
Cladribine therapy was given to all patients at a dose of 0.09 mg/Kg continuous I.V. infusion for 7 days.
Patients were reevaluated 3 months, 6 months and at last follow up (3-5 years) after cladribine therapy with CBC, bone marrow aspirate, abdominal Ultrasonography and, immunophenotyping .
Evaluation at five years of follow up revealed complete clinical and laboratory responses in 32/33 patients (97%).Treatment related mortality one patient (3%); at 6 months post treatment .The disease free and overall survival at 3 years were the same 97%, while the PFS was 90.9%.
In conclusion, the extended follow up of our patients with HCL patients confirms that Cladrabine is a safe and effective treatment for patients with HCL. The majority of patients achieved complete remission. Purine nucleoside analogues are currently the treatment of choice for HCL. Cladrabine has the advantage of a single administration over 7 days, compared with pentostatin, which is given every 2 weeks until best response, which is usually 3 to 6 months in duration. Novel treatment modalities must be interpreted within this context.
Aim of the study:
1- Cladribine leads to Complete Remission rates up to 90% in patients with Hairy Cell Leukemia.
2- The overall response at three years is 97%.
3- Progression free survival at five years is 90.9%.
4- Cladribine is safe and effective in treatment of HCL.
AIM &METHODS:
In the current study thirty three patients with hairy cell leukemia presented to the Hematology Department at Nasser Institute hospital in the period from January 2000 to June 2010. The male to female ratio was 3.7:1 with a mean age of 44.5 years (29-67); one of these patients underwent splenectomy before therapy. Splenomegaly was found in 32/33 (96.9%), while one patient showed no initial splenomegaly. The mean TLC, hemoglobin, and platelet counts before treatment were 2.8x10/L, 8.8 gm/dl, and 61.000 /mm3 respectively, 93.9% of our patients (31/33) showed infiltration by hairy cells in their bone marrow aspirate .TRAP test was positive in 30 out of 33 patients (90.9%).Immunophenotyping of the bone marrow aspirate revealed CD 103 and CD 25 positivity in 84.8 % and 63.6% of our patients respectively.
Cladribine therapy was given to all patients at a dose of 0.09 mg/Kg continuous I.V. infusion for 7 days.
Patients were reevaluated 3 months, 6 months and at last follow up (3-5 years) after cladribine therapy with CBC, bone marrow aspirate, abdominal Ultrasonography and, immunophenotyping .
Evaluation at five years of follow up revealed complete clinical and laboratory responses in 32/33 patients (97%).Treatment related mortality one patient (3%); at 6 months post treatment .The disease free and overall survival at 3 years were the same 97%, while the PFS was 90.9%.
In conclusion, the extended follow up of our patients with HCL patients confirms that Cladrabine is a safe and effective treatment for patients with HCL. The majority of patients achieved complete remission. Purine nucleoside analogues are currently the treatment of choice for HCL. Cladrabine has the advantage of a single administration over 7 days, compared with pentostatin, which is given every 2 weeks until best response, which is usually 3 to 6 months in duration. Novel treatment modalities must be interpreted within this context.
Aim of the study:
1- Cladribine leads to Complete Remission rates up to 90% in patients with Hairy Cell Leukemia.
2- The overall response at three years is 97%.
3- Progression free survival at five years is 90.9%.
4- Cladribine is safe and effective in treatment of HCL.
Other data
| Title | Results of Cladribine in Hairy Cell Leukemia: Nasser Institute Experience. | Other Titles | نتائج استخدام عقار كلادرابين في علاج مرض ليوكيميا الخلايا المشعره | Authors | Haitham Elsayd Sherif | Issue Date | 2015 |
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