Long-term follow-up of front-line treatment of hairy cell leukemia with 2-chlorodeoxyadenosine

Pier Luigi Zinzani, Monica Tani, Enrica Marchi, Vittorio Stefoni, Lapo Alinari, Gerardo Musuraca, Annalisa Gabriele, Stefano Pileri, Michele Baccarani

Research output: Contribution to journalArticle

Abstract

Background and Objectives. Although remission of hairy cell leukemia (HCL) after treatment with 2-chlorodeoxyadenosine (2-CdA) appears to be long lasting, few reports currently provide results from follow-up exceeding 5 years. Design and Methods. We reviewed our HCL patients treated with front-line 2-CdA (by 2-hour infusion) either for 5 consecutive days at 0.14 mg/kg/day (daily subset, n=21) or once a week at 0.14 mg/kg for 5 cycles (weekly subset, n=16). Results. Of the 37 eligible patients, 30 (81%) achieved complete response (CR) and 7 (19%) partial response (PR) (overall response rate, 100%); identical response rates were recorded in the daily and weekly subsets. After a median follow-up of 122 months (range, 54-156), the overall relapse rate was 27% (8/30): 24% (4/17) had relapsed in the subset treated daily whereas 30% (4/13) had done so in the subset treated weekly (p=ns). The projected 13-year overall and the relapse-free survivals are 96% and 52%, respectively. In terms of hematologic toxicity, the weekly 2-CdA schedule was associated with significantly fewer cases of grade 3-4 neutropenia. Interpretation and Conclusions. In HCL patients, a single dose of 2-CdA induces a long-term CR. Over 90% of patients are alive 13 years later and over 50% of patients appear to be clinically cured by this treatment. The weekly schedule seems to be a safer option for neutropenic HCL patients, while apparently providing equivalent results in terms of response rates and long-term outcome.

Original languageEnglish
Pages (from-to)309-313
Number of pages5
JournalHaematologica
Volume89
Issue number3
Publication statusPublished - Mar 2004

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Keywords

  • 2-chlorodeoxyadenosine
  • Hairy cell leukemia
  • Hematologic toxicity
  • Long-term follow-up
  • Neutropenia

ASJC Scopus subject areas

  • Hematology

Cite this

Zinzani, P. L., Tani, M., Marchi, E., Stefoni, V., Alinari, L., Musuraca, G., Gabriele, A., Pileri, S., & Baccarani, M. (2004). Long-term follow-up of front-line treatment of hairy cell leukemia with 2-chlorodeoxyadenosine. Haematologica, 89(3), 309-313.