Long-term follow-up of 233 patients with hairy cell leukaemia, treated initially with pentostatin or cladribine, at a median of 16 years from diagnosis

Autor: Nnenna Osuji, S. A. Johnson, Claire Dearden, Juan Garcia-Talavera, Monica Else, Estella Matutes, Daniel Catovsky, Ama Z. S. Rohatiner, Francesco Lauria, Francesco Forconi, Nigel T. J. O’Connor, A P Haynes
Rok vydání: 2009
Předmět:
Murine-Derived
Adult
Male
medicine.medical_specialty
Hairy Cell
medicine.drug_class
Purine analogue
Kaplan-Meier Estimate
Gastroenterology
Antimetabolite
Antibodies
Adult
Aged
Antibodies
Monoclonal
Murine-Derived
Antibodies
administration /&/ dosage
Antineoplastic Combined Chemotherapy Protocols
therapeutic use
Cladribine
administration /&/ dosage
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Leukemia
drug therapy/mortality
Male
Middle Aged
Pentostatin
administration /&/ dosage
Recurrence
Remission Induction
Survival Rate
Treatment Outcome
Antibodies
Monoclonal
Murine-Derived
Recurrence
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
drug therapy/mortality
Humans
Medicine
Pentostatin
Hairy cell leukemia
administration /&/ dosage
Cladribine
Survival rate
Aged
Leukemia
Hairy Cell
Leukemia
business.industry
Remission Induction
Antibodies
Monoclonal
Hematology
Middle Aged
medicine.disease
Surgery
Survival Rate
Treatment Outcome
therapeutic use
Female
Rituximab
business
Follow-Up Studies
medicine.drug
Zdroj: British Journal of Haematology. 145:733-740
ISSN: 1365-2141
0007-1048
Popis: Hairy cell leukaemia (HCL) was first described 50 years ago. Median survival was then 4 years. The purine analogues, introduced in the 1980s, transformed this prognosis. We reviewed data retrospectively from 233 patients, treated with pentostatin (n = 188) or cladribine (n = 45), to investigate the current long-term outlook. Median follow-up was 16 years. There were no significant differences in outcome between the two agents. Overall, the complete response (CR) rate was 80% and median relapse-free survival was 16 years. After relapse (n = 79) or non-response (n = 5), 26 patients received pentostatin and 58 cladribine; 69% achieved CR and median relapse-free survival was 11 years. After third-line therapy (n = 23), 50% achieved CR and median relapse-free survival was 6.5 years. However, CRs were equally durable, whether after first, second or third-line therapy. Complete responders and those with both haemoglobin >100 g/l and platelet count >100 x 10(9)/l before treatment had the longest relapse-free survival (P < 0.0001). Patients still in CR at 5 years had only a 25% risk of relapse by 15 years. Outcomes for patients with recurrent disease improved with the monoclonal antibody rituximab, combined with either purine analogue. Overall only eight patients died of HCL-related causes. Patients achieving a CR can expect a normal lifespan.
Databáze: OpenAIRE
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