Long Term Outcomes of Hairy Cell Leukemia Treated with Purine Analogs: a Comparison to the General Population

Publication date: Available online 14 July 2017 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Yazan F. Madanat, Lisa Rybicki, Tomas Radivoyevitch, Deepa Jagadeesh, Robert Dean, Brad Pohlman, Matt Kalaycio, Mikkael A. Sekeres, Mitchell R. Smith, Brian T. Hill Hairy Cell Leukemia (HCL) is a rare hematologic malignancy with high response rates and long progression-free survival (PFS) after treatment with purine nucleoside analogs [PNAs; Pentostatin/ Cladribine]. However, treatment is not curative and subsequent treatment at relapse is often required. Re-challenge with a purine analog is commonly implemented despite limited data regarding the efficacy of this approach. We retrospectively analyzed 61 consecutive HCL patients diagnosed between 1995 and 2013 at Cleveland Clinic. Median follow up was 72 months (3 to 193). Cladribine as first line therapy was administered to 59 patients (97%). Overall Response Rate (ORR) was 97% with 78% of patients achieving complete remission (CR). PFS after response was significantly improved for patients who achieved CR compared to those with a partial remission (PR) [5 year PFS 71% vs. 39% respectively (P=0.004)]. Of the 19 patients who relapsed, 12 received PNAs as second line treatment with an ORR (83%) comparable to what these patients had with first line treatment (ORR 92%). Overall survival (OS) of all 61 patients was excellent and superior to that of age-, sex- and race-matched controls from the general population, po...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research