title: Long-term follow-up of front-line treatment of hairy cell leukemia with 2-chlorodeoxyadenosine.
abstract: OBJECTIVE
  Although remission of hairy cell leukemia (HCL) after treatment with 2-chlorodeoxyadenosine (2-CdA) appears to be long lasting, few reports currently provide results from follow-up exceeding 5 years.
  
  
  METHODS
  We reviewed our HCL patients treated with front-line 2-CdA (by 2-hour infusion) either for 5 consecutive days at 0.14 mg/kg/day (daily subset, n=21) or once a week at 0.14 mg/kg for 5 cycles (weekly subset, n=16).
  
  
  RESULTS
  Of the 37 eligible patients, 30 (81%) achieved complete response (CR) and 7 (19%) partial response (PR) (overall response rate, 100%); identical response rates were recorded in the daily and weekly subsets. After a median follow-up of 122 months (range, 54-156), the overall relapse rate was 27% (8/30): 24% (4/17) had relapsed in the subset treated daily whereas 30% (4/13) had done so in the subset treated weekly (p=ns). The projected 13-year overall and the relapse-free survivals are 96% and 52%, respectively. In terms of hematologic toxicity, the weekly 2-CdA schedule was associated with significantly fewer cases of grade 3-4 neutropenia.
  
  
  CONCLUSIONS
  In HCL patients, a single dose of 2-CdA induces a long-term CR. Over 90% of patients are alive 13 years later and over 50% of patients appear to be clinically cured by this treatment. The weekly schedule seems to be a safer option for neutropenic HCL patients, while apparently providing equivalent results in terms of response rates and long-term outcome.
authors.affiliation: Institute of Hematology and Medical Oncology L. e A. Seràgnoli, University of Bologna, Italy. plzinzo@med.unibo.it
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Zinzani
authors.forename: Monica
authors.initials: M
authors.lastname: Tani
authors.forename: Enrica
authors.initials: E
authors.lastname: Marchi
authors.forename: Vittorio
authors.initials: V
authors.lastname: Stefoni
authors.forename: Lapo
authors.initials: L
authors.lastname: Alinari
authors.forename: Gerardo
authors.initials: G
authors.lastname: Musuraca
authors.forename: Annalisa
authors.initials: A
authors.lastname: Gabriele
authors.forename: Stefano
authors.initials: S
authors.lastname: Pileri
authors.forename: Michele
authors.initials: M
authors.lastname: Baccarani
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017338:Cladribine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007943:Leukemia, Hairy Cell / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D017338:Cladribine