Hairy cell leukemia (HCL) with extensive myelofibrosis responds to thalidomide.
We present a 75-year-old man who was admitted to our hospital because of splenomegaly, transfusion-dependent anemia and thrombocytopenia. The diagnosis of idiopathic myelofibrosis was suggested by the bone marrow trephine biopsy, which was hypocellular with myelofibrosis. Thalidomide was started at a daily dose of 100 mg/d and increased to 400 mg/d. Within 12 weeks, thrombocytes increased to 100.000/microl, hemoglobin normalized, lasting for about 11 months. Then, thalidomide had to be discontinued because of mild polyneuropathy. A second bone marrow biopsy showed fibrosis as well as a diffuse infiltration of the bone marrow (80%) by lymphocytes with expression of CD11c, CD19, CD20, CD103. Tartrate resistant acid phosphatase test (TRAP) was also positive. Hairy cell leukemia was diagnosed and he was administered 2-chlorodeoxyadenosine (2-CDA) achieving a complete remission.
Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Moorenstr. 5, 40225 Düsseldorf, Germany. c.strupp@web.de
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Strupp
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Fenk
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Kündgen
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Gattermann
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Haas
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Germing
D000368:Aged; D017338:Cladribine / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007943:Leukemia, Hairy Cell / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D055728:Primary Myelofibrosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D012074:Remission Induction; D013792:Thalidomide / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D017338:Cladribine; D013792:Thalidomide