Long-term outcome following treatment of hairy cell leukemia with pentostatin (Nipent): a National Cancer Institute of Canada study.
We have previously demonstrated that pentostatin (Nipent; SuperGen, San Ramon, CA) is highly effective in the treatment of hairy cell leukemia and report here the long-term outcome of this study. Pentostatin was administered intravenously in cycles of 4 mg/m2 weekly x 3 repeated every 8 weeks. Patients who achieved a complete remission (CR) received two further cycles for consolidation. Of 28 evaluable patients, 25 achieved a CR and three a partial remission. Twenty-three patients are alive at a median follow-up duration of 118 months (range, 55 to 133 months). Of the 25 patients who achieved a CR, 14 (56%) remain in CR at a median of 119 months (range, 109 to 133 months) from the time of CR. Nine additional patients relapsed at a median time of 49 months (range, 15 to 122 months). Only three of the relapsed patients have required treatment: two patients who received cladribine achieved CRs; the third received interferon-alpha and died from hairy cell leukemia. The three patients in partial remission continue to have normal blood counts at 58, 105, and 120 months. Five patients have developed a second malignancy: one mycosis fungoides and four solid tumors. Three patients died from the second malignancies. There were no treatment-related deaths due to toxicity or opportunistic infection. Pentostatin is a highly effective agent for hairy cell leukemia and produces prolonged remissions in the majority of patients.
Johnston
J B
JB
Manitoba Cancer Treatment and Research Foundation, Winnipeg, Canada.
Eisenhauer
E
E
Wainman
N
N
Corbett
W E
WE
Zaentz
S D
SD
Daeninck
P J
PJ
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002170:Canada; D002423:Cause of Death; D017338:Cladribine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007275:Injections, Intravenous; D016898:Interferon-alpha / Q000627:therapeutic use; D007943:Leukemia, Hairy Cell / Q000188:drug therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000473:pathology; D015649:Pentostatin / Q000008:administration & dosage / Q000627:therapeutic use*; D012074:Remission Induction; D015996:Survival Rate; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D016898:Interferon-alpha; D015649:Pentostatin; D017338:Cladribine