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Long-lasting complete remission in patients with hairy cell leukemia treated with 2-CdA: a 5-year survey

Long-lasting complete remission in patients with hairy cell leukemia treated with 2-CdA: a 5-year survey
Long-lasting complete remission in patients with hairy cell leukemia treated with 2-CdA: a 5-year survey
Between January 1991 and January 1994, 40 patients with hairy-cell leukemia (HCL), 30 males and 10 females, with a median age of 54 years, were treated with a single course of 2-chlorodeoxyadenosine (2-CdA) at a dose of 0.1 mg/kg/day continuous infusion for 7 days. Thirteen patients were untreated and 27 had previously received alpha-interferon. Thirty out of 40 patients (75%) achieved complete remission (CR) and 10 (25%) partial remission (PR). The median follow-up duration for patients in CR has been 48 months (range 30-66). Five of the complete responders (17%) relapsed at 12, 24, 26, 30 and 36 months after treatment as documented by the increase of hairy cells (Hc) in the bone marrow and two of them, who were retreated with 2-CdA after showing an initial impairment of peripheral blood values, obtained a second CR. The remaining three relapsed patients were never retreated and still show normal peripheral counts after 30, 38 and 40 months. Twelve of the continuous complete responder patients are still in CR after more than 5 years. In contrast, 8 out of 10 partial responders progressed after 8-36 months and all of them were retreated with 2-CdA at a dose of 0.15 mg/kg/day for 5 days i.v. Four of them (50%) achieved a CR, three a better PR and one patient died 6 months after the second 2-CdA course because of infectious complications. Two additional patients, both in CR, died after 28 and 37 months because of a second neoplasm. Toxic side-effects consisted of febrile episodes recorded in 16 patients: in seven of them, fever lasted only 24-48 h after the end of treatment and was apparently not infection-related. In the remaining nine patients, showing in addition severe neutropenia (neutrophils less than 1.0 x 10(9)/l), fever was related to bacterial infection requiring systemic antibiotics in all of them and G-CSF in three cases. In conclusion, 2-CdA induces a very high proportion of complete and long-lasting remissions in patients with HCL. In a number of cases relapse at bone marrow level may not affect peripheral blood values for prolonged time. However, in those patients with initial pancytopenia a retreatment with 2-CdA is still effective in inducing a durable second CR.
HCL, 2-CdA, CR, lymphocytopenia
0887-6924
629-632
Lauria, F.
735fa868-573e-4a9b-b409-a3316d397c4a
Rondelli, D.
e7380678-2518-42cb-ae10-d4ef8b900417
Zinzani, P. L.
565b4fab-f99d-44c7-8a39-8f0a7a3e20de
Bocchia, M.
469a1dc3-f5f8-4aa9-8837-6906eb0a23b3
Marotta, G.
9a4694bf-492a-4bd0-9b21-43cdad1f78f5
Salvucci, M.
c6799c45-8e71-4116-bff2-cba58b89bae9
Raspadori, D.
bf030b4a-d671-41d0-bd9f-fac632ed88c8
Ventura, M. A.
3214389e-be33-4bcd-889d-624370098eae
Birtolo, S.
f6d1b67c-2335-4946-b835-5d4a5b5ec78d
Forconi, Francesco
ce9ed873-58cf-4876-bf3a-9ba1d163edc8
Tura, S.
eed48885-b319-4446-a488-c3193a83c2bc
Lauria, F.
735fa868-573e-4a9b-b409-a3316d397c4a
Rondelli, D.
e7380678-2518-42cb-ae10-d4ef8b900417
Zinzani, P. L.
565b4fab-f99d-44c7-8a39-8f0a7a3e20de
Bocchia, M.
469a1dc3-f5f8-4aa9-8837-6906eb0a23b3
Marotta, G.
9a4694bf-492a-4bd0-9b21-43cdad1f78f5
Salvucci, M.
c6799c45-8e71-4116-bff2-cba58b89bae9
Raspadori, D.
bf030b4a-d671-41d0-bd9f-fac632ed88c8
Ventura, M. A.
3214389e-be33-4bcd-889d-624370098eae
Birtolo, S.
f6d1b67c-2335-4946-b835-5d4a5b5ec78d
Forconi, Francesco
ce9ed873-58cf-4876-bf3a-9ba1d163edc8
Tura, S.
eed48885-b319-4446-a488-c3193a83c2bc

Lauria, F., Rondelli, D., Zinzani, P. L., Bocchia, M., Marotta, G., Salvucci, M., Raspadori, D., Ventura, M. A., Birtolo, S., Forconi, Francesco and Tura, S. (1997) Long-lasting complete remission in patients with hairy cell leukemia treated with 2-CdA: a 5-year survey. Leukemia, 11 (5), 629-632. (PMID:9180283)

Record type: Article

Abstract

Between January 1991 and January 1994, 40 patients with hairy-cell leukemia (HCL), 30 males and 10 females, with a median age of 54 years, were treated with a single course of 2-chlorodeoxyadenosine (2-CdA) at a dose of 0.1 mg/kg/day continuous infusion for 7 days. Thirteen patients were untreated and 27 had previously received alpha-interferon. Thirty out of 40 patients (75%) achieved complete remission (CR) and 10 (25%) partial remission (PR). The median follow-up duration for patients in CR has been 48 months (range 30-66). Five of the complete responders (17%) relapsed at 12, 24, 26, 30 and 36 months after treatment as documented by the increase of hairy cells (Hc) in the bone marrow and two of them, who were retreated with 2-CdA after showing an initial impairment of peripheral blood values, obtained a second CR. The remaining three relapsed patients were never retreated and still show normal peripheral counts after 30, 38 and 40 months. Twelve of the continuous complete responder patients are still in CR after more than 5 years. In contrast, 8 out of 10 partial responders progressed after 8-36 months and all of them were retreated with 2-CdA at a dose of 0.15 mg/kg/day for 5 days i.v. Four of them (50%) achieved a CR, three a better PR and one patient died 6 months after the second 2-CdA course because of infectious complications. Two additional patients, both in CR, died after 28 and 37 months because of a second neoplasm. Toxic side-effects consisted of febrile episodes recorded in 16 patients: in seven of them, fever lasted only 24-48 h after the end of treatment and was apparently not infection-related. In the remaining nine patients, showing in addition severe neutropenia (neutrophils less than 1.0 x 10(9)/l), fever was related to bacterial infection requiring systemic antibiotics in all of them and G-CSF in three cases. In conclusion, 2-CdA induces a very high proportion of complete and long-lasting remissions in patients with HCL. In a number of cases relapse at bone marrow level may not affect peripheral blood values for prolonged time. However, in those patients with initial pancytopenia a retreatment with 2-CdA is still effective in inducing a durable second CR.

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More information

Published date: May 1997
Keywords: HCL, 2-CdA, CR, lymphocytopenia
Organisations: Cancer Sciences

Identifiers

Local EPrints ID: 358193
URI: http://eprints.soton.ac.uk/id/eprint/358193
ISSN: 0887-6924
PURE UUID: ddb4a966-f1dd-4712-8e99-b5a3801830e9
ORCID for Francesco Forconi: ORCID iD orcid.org/0000-0002-2211-1831

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Date deposited: 11 Oct 2013 11:43
Last modified: 24 Nov 2022 02:44

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Contributors

Author: F. Lauria
Author: D. Rondelli
Author: P. L. Zinzani
Author: M. Bocchia
Author: G. Marotta
Author: M. Salvucci
Author: D. Raspadori
Author: M. A. Ventura
Author: S. Birtolo
Author: S. Tura

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