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Rituximab with pentostatin or cladribine: an effective combination treatment for hairy cell leukemia after disease recurrence

Rituximab with pentostatin or cladribine: an effective combination treatment for hairy cell leukemia after disease recurrence
Rituximab with pentostatin or cladribine: an effective combination treatment for hairy cell leukemia after disease recurrence
The purine analogs pentostatin and cladribine are effective treatments for hairy cell leukemia (HCL). However, alternative treatments are needed for patients with recurrent disease. We reviewed retrospectively data from 18 patients who were retreated with either pentostatin (n?=?12) or cladribine (n?=?6) in combination with rituximab, after 1-6 (median 2) previous treatments with either purine analog as a single agent. All 18 patients responded to therapy, with a complete response (CR) rate of 89%. This compared favorably with CR rates of 68% after second-line therapy and 47% after third-line therapy in 88 patients retreated one or more times with a purine analog alone. Toxicity with the combination treatment was minimal. At a median follow-up of 36 months (range 5-83 months) all 16 complete responders remained in CR, while one partial responder developed recurrent disease at 10 months. The estimated recurrence rate at 3 years was 7%. This compares with 21% after second-line therapy and 42% after third-line therapy in the 88 patients retreated with a purine analog alone. Furthermore, it was a marked improvement on the 55% recurrence at 3 years previously seen in these same 18 patients after their own first-line treatment with single-agent pentostatin or cladribine (p?=?0.006). The combination of a purine analog with rituximab was safe and effective for patients with recurrent HCL. The results suggest an added benefit compared with single-agent purine analog therapy.
hairy cell leukemia, rituximab, pentostatin, cladribine
1042-8194
75-78
Else, Monica
3d354259-1969-4d47-9eea-5b95daaf2089
Dearden, Claire E.
7bf313f7-6e4e-4660-a1a1-65cfd21afb9f
Matutes, Estella
3da6561d-9c65-48b3-9273-db3c93f77a80
Forconi, Francesco
ce9ed873-58cf-4876-bf3a-9ba1d163edc8
Lauria, Francesco
f01f163b-abcb-4aad-b952-f4356692f519
Ahmad, Humayun
e025a021-35b6-4c50-80c0-1142e296a3b6
Kelly, Susan
21a70843-a498-4987-95ad-6505c7a7e34c
Liyanage, Anandika
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Ratnayake, Vijitha
3e6686d0-7249-40bb-b753-05cb94d9ca0a
Shankari, Jagadeesan
5de3d168-6ba9-47d0-b859-473f2ab504e6
Whalley, Ioana
ba29d618-0f32-4a8b-b818-7253b80b71f3
Catovsky, Daniel
0c2a5c78-d841-456e-88c7-581850d4e80a
Else, Monica
3d354259-1969-4d47-9eea-5b95daaf2089
Dearden, Claire E.
7bf313f7-6e4e-4660-a1a1-65cfd21afb9f
Matutes, Estella
3da6561d-9c65-48b3-9273-db3c93f77a80
Forconi, Francesco
ce9ed873-58cf-4876-bf3a-9ba1d163edc8
Lauria, Francesco
f01f163b-abcb-4aad-b952-f4356692f519
Ahmad, Humayun
e025a021-35b6-4c50-80c0-1142e296a3b6
Kelly, Susan
21a70843-a498-4987-95ad-6505c7a7e34c
Liyanage, Anandika
4e22f5f3-8182-46e8-b678-3952681ace51
Ratnayake, Vijitha
3e6686d0-7249-40bb-b753-05cb94d9ca0a
Shankari, Jagadeesan
5de3d168-6ba9-47d0-b859-473f2ab504e6
Whalley, Ioana
ba29d618-0f32-4a8b-b818-7253b80b71f3
Catovsky, Daniel
0c2a5c78-d841-456e-88c7-581850d4e80a

Else, Monica, Dearden, Claire E., Matutes, Estella, Forconi, Francesco, Lauria, Francesco, Ahmad, Humayun, Kelly, Susan, Liyanage, Anandika, Ratnayake, Vijitha, Shankari, Jagadeesan, Whalley, Ioana and Catovsky, Daniel (2011) Rituximab with pentostatin or cladribine: an effective combination treatment for hairy cell leukemia after disease recurrence. Leukemia and Lymphoma, 52, supplement 2, 75-78. (doi:10.3109/10428194.2011.568650). (PMID:21504288)

Record type: Article

Abstract

The purine analogs pentostatin and cladribine are effective treatments for hairy cell leukemia (HCL). However, alternative treatments are needed for patients with recurrent disease. We reviewed retrospectively data from 18 patients who were retreated with either pentostatin (n?=?12) or cladribine (n?=?6) in combination with rituximab, after 1-6 (median 2) previous treatments with either purine analog as a single agent. All 18 patients responded to therapy, with a complete response (CR) rate of 89%. This compared favorably with CR rates of 68% after second-line therapy and 47% after third-line therapy in 88 patients retreated one or more times with a purine analog alone. Toxicity with the combination treatment was minimal. At a median follow-up of 36 months (range 5-83 months) all 16 complete responders remained in CR, while one partial responder developed recurrent disease at 10 months. The estimated recurrence rate at 3 years was 7%. This compares with 21% after second-line therapy and 42% after third-line therapy in the 88 patients retreated with a purine analog alone. Furthermore, it was a marked improvement on the 55% recurrence at 3 years previously seen in these same 18 patients after their own first-line treatment with single-agent pentostatin or cladribine (p?=?0.006). The combination of a purine analog with rituximab was safe and effective for patients with recurrent HCL. The results suggest an added benefit compared with single-agent purine analog therapy.

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More information

Published date: June 2011
Keywords: hairy cell leukemia, rituximab, pentostatin, cladribine
Organisations: Cancer Sciences

Identifiers

Local EPrints ID: 358127
URI: http://eprints.soton.ac.uk/id/eprint/358127
ISSN: 1042-8194
PURE UUID: c7abc2ef-7a97-466b-87fe-f15fa9c94a53
ORCID for Francesco Forconi: ORCID iD orcid.org/0000-0002-2211-1831

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Date deposited: 08 Oct 2013 09:45
Last modified: 15 Mar 2024 03:40

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Contributors

Author: Monica Else
Author: Claire E. Dearden
Author: Estella Matutes
Author: Francesco Lauria
Author: Humayun Ahmad
Author: Susan Kelly
Author: Anandika Liyanage
Author: Vijitha Ratnayake
Author: Jagadeesan Shankari
Author: Ioana Whalley
Author: Daniel Catovsky

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