Faculty Collaboration Database

Treatment of hairy cell leukemia with 2-chlorodeoxyadenosine (2-CdA). Blood 1992 Feb 15;79(4):882-7

Date

02/15/1992

Pubmed ID

1346577

Scopus ID

2-s2.0-0026513828 (requires institutional sign-in at Scopus site)   181 Citations

Abstract

We administered one course of 2-chlorodeoxyadenosine (2CdA) at 4 mg/m2 daily for 7 days by continuous intravenous infusion to 46 patients with hairy cell leukemia. Complete remissions occurred in 36 patients (78%; 95% confidence limits, 63% to 89%), partial remissions in five (11%), and a minor response in one. One patient died of candida sepsis 3 weeks after beginning treatment and three patients were clearly resistant to therapy. These three either had morphologically atypical hairy cells, less than 20% of which expressed Ig light chain on the cell surface, or had failed prior treatment with deoxycoformycin and interferon-alpha. At a median of 37 weeks since discontinuation of therapy, recurrent thrombocytopenia has developed in one patient, whose marrow remains normal, while a bone marrow relapse has occurred in another patient, whose blood counts remain normal. Treatment produced a greater than 50% decrease in neutrophil count in 26 patients, which lasted 3 to 4 weeks and was associated with an increased incidence of febrile episodes. These episodes occurred in 21 patients but were associated with documented infection in only four patients. Decreases in the number of CD4+ lymphocytes appeared to occur regularly after treatment and have persisted for a median of 18 weeks without obvious clinical significance. Although years of follow-up will be needed, our results confirm Piro et al's observation (N Engl J Med 322: 1117, 1990) that 2CdA appears to be highly effective in the treatment of hairy cell leukemia.

Author List

Estey EH, Kurzrock R, Kantarjian HM, O'Brien SM, McCredie KB, Beran M, Koller C, Keating MJ, Hirsch-Ginsberg C, Huh YO

Author

Razelle Kurzrock MD Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

2-Chloroadenosine
Antineoplastic Agents
Cladribine
Deoxyadenosines
Drug Resistance
Humans
Leukemia, Hairy Cell
Leukocyte Count
Leukopenia
Male
Middle Aged
Neutrophils
Platelet Count
Remission Induction
T-Lymphocytes, Helper-Inducer
T-Lymphocytes, Regulatory