Fludarabine: an effective treatment in patients with splenic lymphoma with villous lymphocytes.
Splenic lymphoma with villous lymphocytes (SLVL) is a B cell chronic lymphoproliferative disorder. Splenectomy and/or chlorambucil are usually regarded as the most effective treatment in SLVL patients. However, a few patients relapse and the second-line treatment remains questionable. In a retrospective study, we evaluated the efficacy and toxicity of fludarabine (FDR) in 10 SLVL patients. The median duration between diagnosis and treatment was 17 months (range, 1-30). Two patients were previously untreated. The patients received FDR 25 mg/m2/day by venous infusion for 5 days with a median of four cycles of chemotherapy (range, 2-6). All patients were assessable: five patients achieved a good and persistent response after a median follow-up of 14 months (5-31), two achieved a good response but relapsed after a follow-up of 15 and 36 months. One out of the three partial responders have a persistent response. The treatment was well tolerated. FDR appears to be an efficient therapy with a favorable toxicity profile for patients in relapse after splenectomy or resistant to CLB. Furthermore it could constitute an alternative to splenectomy in older patients. A longer follow-up and the study of a larger group of patients are warranted to confirm our findings.
Lefrère
F
F
Service d'Hématologie Adultes, Hôpital Necker, Paris, France.
Hermine
O
O
Belanger
C
C
François
S
S
Tilly
H
H
Lebas de La Cour
J C
JC
Valensi
F
F
Varet
B
B
Troussard
X
X
D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002699:Chlorambucil / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004341:Drug Evaluation; D019008:Drug Resistance, Neoplasm; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D016898:Interferon-alpha / Q000627:therapeutic use; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012074:Remission Induction; D012189:Retrospective Studies; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000188:drug therapy* / Q000601:surgery; D014740:Vidarabine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000964:Antimetabolites, Antineoplastic; D018906:Antineoplastic Agents, Alkylating; D007155:Immunologic Factors; D016898:Interferon-alpha; D002699:Chlorambucil; D014740:Vidarabine; C024352:fludarabine