Hairy cell leukemia treated initially with purine analogs: a retrospective study of 107 patients from the Spanish Cooperative Group on Chronic Lymphocytic Leukemia (GELLC)

Autores de IIS La Fe

• Eva María Colado Perez

  Autor

• Federico Gomis Bernal

  Autor

• Isidro Jarque Ramos

  Autor

• Maria Fernanda Vargas Gamarra

  Autor

• María Encarnacion Monzo Castellano

  Autor

• Fernando Carbonell Tatay

  Autor

Participantes ajenos a IIS La Fe

• López Rubio M
• Da Silva C
• Loscertales J
• Seri C
• Baltasar P
• Pérez Fernández I
• Osma M
• González M
• Monteagudo D
• Orts MI
• Pardal E
• Perez Calvo C
• Garcia-Marco JA

Grupos

• Hematología y Hemoterapia

  

  Investigador Principal

  Javier De La Rubia Comos

Abstract

Purine analogs are highly effective in hairy cell leukemia (HCL) with response rates of 85%, but with many late relapses. We have retrospectively reviewed the clinical data from 107 patients treated with pentostatin (n = 27) or cladribine (n = 80), to investigate the long-term efficacy and to identify factors associated with the treatment-free interval (TFI). Complete remission and minimal residual disease (MRD) rates were similar in both groups. Median TFI was shorter (95 vs. 144 months) in the pentostatin group, although the difference was not significant (p = 0.476). MRD+ patients had shorter TFI than MRD - patients (97 months vs. not reached, p < 0.049). A hemoglobin level < 10 g/dL predicted for a shorter TFI only in the pentostatin group. Quality of response and number of hairy cells in the bone marrow are independent risk factors of treatment failure. The relationship between MRD+ and shorter TFI makes it of special interest to explore consolidation therapy with monoclonal antibodies to achieve durable responses.

Keywords

• Hairy cell leukemia; pentostatin; cladribine