title: Very long-term eradication of minimal residual disease in patients with hairy cell leukemia after a single course of cladribine.
abstract: Cladribine induces protracted remissions in patients with hairy cell leukemia (HCL). However, many long-term responders ultimately relapse. We sought to determine whether long-term complete responders subsequent to a single 7-day course of cladribine were without minimal residual disease (MRD) and potentially cured of HCL. From the 358-person Scripps Clinic cladribine database, we identified 19 patients in continuous and complete hematologic response (median age, 75 years; median time from diagnosis, 18 years; and median time from cladribine, 16 years). Nine of 19 (47%) patient samples had no evidence of residual disease; 7 of 19 (37%) samples had MRD; and 3 of 19 (16%) had morphologic evidence of HCL in hematoxylin and eosin-stained bone marrow sections. These results indicate that HCL is potentially curable after cladribine treatment. In addition, patients with MRD and even gross morphologic disease can live many years without manifesting hematologic relapses.
authors.affiliation: Division of Hematology/Oncology, Scripps Clinic Medical Group, 10666 N. Torrey Pines Rd, MS217, La Jolla, CA 92037, USA.
authors.forename: Darren S
authors.initials: DS
authors.lastname: Sigal
authors.forename: Robert
authors.initials: R
authors.lastname: Sharpe
authors.forename: Carol
authors.initials: C
authors.lastname: Burian
authors.forename: Alan
authors.initials: A
authors.lastname: Saven
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D017338:Cladribine / Q000008:administration & dosage*; D017322:Clinical Trials, Phase II as Topic; D016208:Databases, Factual; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007943:Leukemia, Hairy Cell / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D017338:Cladribine