Very long-term eradication of minimal residual disease in patients with hairy cell leukemia after a single course of cladribine.
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.
Sigal
Darren S
DS
Division of Hematology/Oncology, Scripps Clinic Medical Group, 10666 N. Torrey Pines Rd, MS217, La Jolla, CA 92037, USA.
Sharpe
Robert
R
Burian
Carol
C
Saven
Alan
A
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
D000970:Antineoplastic Agents; D017338:Cladribine