The results of two-stage treatment scheme application in patients with hairy cell leukemia

Abstract

The analogues of purine nucleosides (pentostatin, cladribine) stay the first line preparations for today. But their use can cause the deep leucopenia and thrombocytopenia that in its turn increases the risk of bacterial, viral and fungal infections, dangerous for the patients’ life. The use of ITF α before 2-СdA course favors the renewal of marrow function and decrease of cytopenia that in its turn allows raise the treatment efficacy and avoid the heavy complications at с 2-СdA therapy.Aim: To analyze the efficacy of two-stage way of treatment in patients with HCL.Methods: The two-stage scheme of HCL treatment was used in 22 patients (14 men and 8 women), whose age median was 49,5 years. At the first stage the ITF α treatment was carried out during 2-4 months. At the second stage of treatment at the improvement of the general patient’s state and hemogram indices, the 2-СdA course was prescribed. Statistical analysis of material was carried out using the packages of applied programs STATISTICA for Windows 5,0. The dynamics of parametric parameters was assessed with the help of Wilcoxon pair criterion. The value р<0,05was considered as a reliable difference.Results: In the result of treatment the full clinical-hematological remission was fixed in 95,5 % of patients, in 4,5 % the partial response to the therapy was fixed. The relapse of disease appeared in 18,2 % of patients during 6-87 months. The analysis of event-free survival (EFS) of patients with HCL after two-stage treatment demonstrated that it is impossible to take into account the median of event-free life of these patients, because the relapse of disease was fixed in less than 50 % of patients, at the same time 25 % of studied persons lived 43,87 months (low quartile).Conclusions: The two-stage method of treatment of patients with HCL allows receive result without heavy complications of the therapy. Such treatment tactics is expedient in patients at the later stages of disease and at significant cytopenia