[Successful ambulatory treatment of patients with hairy-cell leukemia using one cycle of the purine analog cladribine. 'Hemato-oncologic volwassen Nederland' (HOVON) Study Group].
OBJECTIVE
To study the efficacy of a single cycle of 2-chlorodeoxyadenosine (2-CDA) given as a 2-hour infusion on 5 consecutive days, in patients with hairy cell leukaemia (HCL).


METHODS
Non-randomised phase II study in an unselected population.


METHODS
20 centres in the Netherlands and Belgium.


METHODS
Response to treatment was evaluated in 23 patients with a minimum follow-up of 6 months. All patients had proven HCL, were untreated or pretreated with splenectomy and (or) IFN alpha, and had at least one of the following criteria: Hb < 7.3 mmol/l, neutrophils < 1.0 x 10(9)/l, platelets < 100 x 10(9)/l, systemic symptoms or symptomatic splenomegaly. Patients with an active infection were ineligible. Treatment consisted of one cycle of 2-CDA (2-hour i.v. infusion days 1-5, dosage 0.1 mg/kg/day).


RESULTS
Sixteen patients had received no prior treatment. At the 4-week evaluation, most patients (17/23) had improvement in one or two haematological parameters. After 6 months, 6/23 (26%) patients were in haematological remission and 13/23 (57%) were in complete remission. No patient developed progressive disease. Febrile neutropenia developed in 12/23 (52%) patients, with documented infection in three of them. A generalised rash was seen in 9/23 (39%) patients.


CONCLUSIONS
2-CDA appears to be the treatment of choice in patients with HCL. With a single 5-day cycle, over 80% of patients achieved remission.
Raemaekers
J M
JM
Afd. Bloedziekten, Academisch Ziekenhuis, Nijmegen.
van 't Veer
M B
MB
Bogman
M J
MJ
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017338:Cladribine / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007943:Leukemia, Hairy Cell / Q000188:drug therapy* / Q000628:therapy; D012074:Remission Induction; D013156:Splenectomy
D000970:Antineoplastic Agents; D016898:Interferon-alpha; D017338:Cladribine
Succesvolle ambulante behandeling van patiënten met harige-cellenleukemie met één cyclus van het purineanalogon cladribine. Hemato-oncologie volwassenen Nederland' (HOVON)-onderzoeksgroep.