TY - JOUR
T1 - Response to pentostatin in hairy-cell leukemia refractory to interferon-alpha
AU - Ho, A. D.
AU - Thaler, J.
AU - Mandelli, F.
AU - Lauria, F.
AU - Zittoun, R.
AU - Willemze, R.
AU - McVie, G.
AU - Marmont, A. M.
AU - Prummer, O.
AU - Stryckmans, P.
AU - Witt, B.
AU - Suciu, S.
AU - Solbu, G.
AU - De Witte, T.
AU - Bodewadt-Radzun, S.
PY - 1989
Y1 - 1989
N2 - Interferon-alpha (IFN-α) or 2'-deoxycoformycin (pentostatin; DCF) have each been shown to be highly active in hairy-cell leukemia (HCL). In this phase II study of the Leukemia Cooperative Group of the European Organization for Research and Treatment of Cancer (EORTC), the efficacy and toxicity of DCF were investigated in patients who were resistant to IFNα treatment. Resistance was defined as: (1) progressive disease (PD) under IFN-α therapy for more than 2 months; (2) stable disease (SD) after more than 6 months of IFN-α treatment; (3) relapse within 3 months of discontinuing IFN-α; and (4) intolerance to IFN-α because of a World Health Organization (WHO) grade 3 or 4 toxicity. DCF was applied at a dosage of 4 mg/m2 weekly x 3, then 4 mg/m2 every other week x 3. Responders were given a maintenance therapy one a month for a maximum of 6 months. At the time of report, 33 patients with resistant disease were evaluable for response and toxicity. Median duration of IFN-α therapy before DCF administration was 14.7 months (range, 1 to 41 months). Complete remissions (CRs) were achieved in 11 patients and partial remissions (PRs) in 15, resulting in a total response rate of 78.8%. Median interval between beginning of DCF therapy to best response was 3.9 months with a range from 2.0 to 7.0 months. Two patients who achieved PR have relapsed 7 and 14 months after cessation of DCF therapy. The median duration of response was over 1.5 months (range, over 3.0 to over 24.0 months). Three patients died within the first 6 weeks of DCF treatment: one of drug-unrelated cardiomyopathy and two of fungal pneumonia. The patients with early death (n = 3) and nonresponsive disease (n = 4) received IFN-α treatment for a longer period (median, 18.0 months) than did the 26 responsive patients (median, 10.0 months). Major side effects included nausea, skin rash, and infections and were otherwise mild. Thus, DCF is highly active in patients with HCL resistant to IFN-α.
AB - Interferon-alpha (IFN-α) or 2'-deoxycoformycin (pentostatin; DCF) have each been shown to be highly active in hairy-cell leukemia (HCL). In this phase II study of the Leukemia Cooperative Group of the European Organization for Research and Treatment of Cancer (EORTC), the efficacy and toxicity of DCF were investigated in patients who were resistant to IFNα treatment. Resistance was defined as: (1) progressive disease (PD) under IFN-α therapy for more than 2 months; (2) stable disease (SD) after more than 6 months of IFN-α treatment; (3) relapse within 3 months of discontinuing IFN-α; and (4) intolerance to IFN-α because of a World Health Organization (WHO) grade 3 or 4 toxicity. DCF was applied at a dosage of 4 mg/m2 weekly x 3, then 4 mg/m2 every other week x 3. Responders were given a maintenance therapy one a month for a maximum of 6 months. At the time of report, 33 patients with resistant disease were evaluable for response and toxicity. Median duration of IFN-α therapy before DCF administration was 14.7 months (range, 1 to 41 months). Complete remissions (CRs) were achieved in 11 patients and partial remissions (PRs) in 15, resulting in a total response rate of 78.8%. Median interval between beginning of DCF therapy to best response was 3.9 months with a range from 2.0 to 7.0 months. Two patients who achieved PR have relapsed 7 and 14 months after cessation of DCF therapy. The median duration of response was over 1.5 months (range, over 3.0 to over 24.0 months). Three patients died within the first 6 weeks of DCF treatment: one of drug-unrelated cardiomyopathy and two of fungal pneumonia. The patients with early death (n = 3) and nonresponsive disease (n = 4) received IFN-α treatment for a longer period (median, 18.0 months) than did the 26 responsive patients (median, 10.0 months). Major side effects included nausea, skin rash, and infections and were otherwise mild. Thus, DCF is highly active in patients with HCL resistant to IFN-α.
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M3 - Article
C2 - 2789273
AN - SCOPUS:0024317929
VL - 7
SP - 1533
EP - 1538
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 10
ER -