Long term results of pati ents with hairy cell leukemia treated with cladribine

Abstract

6701 Background: Hairy cell leukemia is a chronic B-cell lymphoproliferative disorder involving bone marrow and spleen. A high complete response rate utilizing cladribine with long durable responses and survival has been documented in a large series (G. Goodman, et al, J. Clin. Onc. 21:891–896, 2003). We have reviewed our long-term experience with hairy cell leukemia treated with cladribine. Methods: We reviewed the results of all patients who had received cladribine ≥5 years ago. From 1992–2000 13 patients received cladribine 0.1 mg/kg/d continuous I.V. infusion for 7 days. Each received one course and were re-evaluated. Patients in complete remission were followed without additional treatment. Patient Characteristics: There were 11 males and 2 females. The ages ranged from 37–76 years (median 54 years). Ten patients were previously untreated. Four patients had previously received interferon with two also receiving prior pentostatin. Responses and Survival: Complete responses characterized by normal blood counts and bone marrow examination were achieved in all 13 patients. Only one cycle of treatment was utilized in each patient. All patients have remained in remission from 4+ -12+ years (median 7+ years). Survival from diagnosis ranges from 4+ - 16+ years (median 9+ years). At 12 years after treatment, survival is projected at 76%. Three patients have expired from atherosclerotic heart disease at 7, 8, and 10 years (ages 78, 79, & 85 years). One patient has developed ovarian cancer at 8 years. One cycle of cladribine can produce long-term responses in patients with hairy cell leukemia. In this small series a pattern of relapses has not been defined. No significant financial relationships to disclose.