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
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
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.
733-740
Else, Monica
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Dearden, Claire E.
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Matutes, Estella
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Garcia-Talavera, Juan
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Rohatiner, Ama Z.S.
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Johnson, Steve A.N.
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O'Connor, Nigel T.J.
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Haynes, Andy
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Osuji, Nnenna
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Forconi, Francesco
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Lauria, Francesco
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Catovsky, Daniel
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June 2009
Else, Monica
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Dearden, Claire E.
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Matutes, Estella
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Garcia-Talavera, Juan
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Rohatiner, Ama Z.S.
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Johnson, Steve A.N.
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O'Connor, Nigel T.J.
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Haynes, Andy
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Osuji, Nnenna
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Forconi, Francesco
ce9ed873-58cf-4876-bf3a-9ba1d163edc8
Lauria, Francesco
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Catovsky, Daniel
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Else, Monica, Dearden, Claire E., Matutes, Estella, Garcia-Talavera, Juan, Rohatiner, Ama Z.S., Johnson, Steve A.N., O'Connor, Nigel T.J., Haynes, Andy, Osuji, Nnenna, Forconi, Francesco, Lauria, Francesco and Catovsky, Daniel
(2009)
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.
British Journal of Haematology, 145 (6), .
(doi:10.1111/j.1365-2141.2009.07668.x).
(PMID:19344416)
Abstract
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.
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e-pub ahead of print date: 29 March 2009
Published date: June 2009
Organisations:
Cancer Sciences
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Local EPrints ID: 358154
URI: http://eprints.soton.ac.uk/id/eprint/358154
ISSN: 0007-1048
PURE UUID: 8c5a356c-38ed-43ac-a883-125923340b41
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Date deposited: 08 Oct 2013 13:03
Last modified: 15 Mar 2024 03:41
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Author:
Monica Else
Author:
Claire E. Dearden
Author:
Estella Matutes
Author:
Juan Garcia-Talavera
Author:
Ama Z.S. Rohatiner
Author:
Steve A.N. Johnson
Author:
Nigel T.J. O'Connor
Author:
Andy Haynes
Author:
Nnenna Osuji
Author:
Francesco Lauria
Author:
Daniel Catovsky
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