Treatment options for hairy-cell leukemia. 1991

H M Golomb, and E Ellis
Department of Medicine, University of Chicago, IL 60637.

In 1991, there are numerous proven therapies for the treatment of hairy-cell leukemia. Since none have been proven to be curative, it is important that all be considered, as individual patients might need to undergo a series of sequential treatments with each. In fact, some elderly patients with minimal splenomegaly and relatively normal blood counts might require no therapy. Splenectomy has a role in rapid reversal of severely depressed blood counts in association with a systemic infection; however, growth factors might soon replace this role of emergency splenectomy. Treatment with recombinant interferon results in few complete remissions, but with normalization of peripheral blood counts in over 80% of patients. In the original interferon alfa-2b study of 195 patients, only three of the 159 patients achieving a normalization of their blood counts have subsequently died. Treatment with deoxycoformycin either after interferon or initially has resulted in an apparent complete remission rate of approximately 60%, but recent follow-up analyses suggest that hairy cells persist within the bone marrow; however, patients seem to remain in a clinical remission. Treatment with 2-chlorodeoxyadenosine shows little toxicity and a high apparent complete remission rate. However, review of the posttreatment bone marrow specimens remains to be done, and longer follow-up is necessary to assess true differences in the degree of response from interferon or deoxycoformycin treatment. Advances in therapy over the past decade have led to significant benefits for patients with hairy-cell leukemia.

UI MeSH Term Description Entries
D007372 Interferons Proteins secreted by vertebrate cells in response to a wide variety of inducers. They confer resistance against many different viruses, inhibit proliferation of normal and malignant cells, impede multiplication of intracellular parasites, enhance macrophage and granulocyte phagocytosis, augment natural killer cell activity, and show several other immunomodulatory functions. Interferon
D007943 Leukemia, Hairy Cell A neoplastic disease of the lymphoreticular cells which is considered to be a rare type of chronic leukemia; it is characterized by an insidious onset, splenomegaly, anemia, granulocytopenia, thrombocytopenia, little or no lymphadenopathy, and the presence of "hairy" or "flagellated" cells in the blood and bone marrow. Hairy Cell Leukemia,Leukemic Reticuloendotheliosis,Reticuloendotheliosis, Leukemic,Hairy Cell Leukemias,Leukemias, Hairy Cell,Leukemic Reticuloendothelioses,Reticuloendothelioses, Leukemic
D012074 Remission Induction Therapeutic act or process that initiates a response to a complete or partial remission level. Induction of Remission,Induction, Remission,Inductions, Remission,Remission Inductions
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013156 Splenectomy Surgical procedure involving either partial or entire removal of the spleen. Splenectomies
D015996 Survival Rate The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods. Cumulative Survival Rate,Mean Survival Time,Cumulative Survival Rates,Mean Survival Times,Rate, Cumulative Survival,Rate, Survival,Rates, Cumulative Survival,Rates, Survival,Survival Rate, Cumulative,Survival Rates,Survival Rates, Cumulative,Survival Time, Mean,Survival Times, Mean,Time, Mean Survival,Times, Mean Survival

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