Long-term follow-up of patients with hairy cell leukemia in the south of Iran

Expert Rev Hematol. 2023 Apr;16(4):289-295. doi: 10.1080/17474086.2023.2174520. Epub 2023 Feb 12.

Abstract

Background: Hairy cell leukemia (HCL) is an indolent chronic lymphoproliferative disorder and first-line treatment with either intravenous or subcutaneous cladribine generally leads to long-lasting remissions.

Method: All 131 patients with hairy-cell leukemia (HCL) were analyzed, with a median follow-up of 91 months. Data is from 2007 to 2020. We evaluated the response rate to cladribine as the first line and the response rate to cladribine with or without rituximab in relapsed patients. Further, we assessed relapse-free survival, complications, and secondary malignancy.

Results: After a median follow-up of 91 months, the recurrence rate was 24%. The 5-year and 10-year RFS rates were 85% and 66%, respectively. Adding rituximab to 2-CDA leads to a better response rate than just cladribine (90% vs. 27.3%, p-value = 0.002) in the relapsed patients.

Conclusion: HCL patients have long-term survival when cladribine is the first line of treatment. Furthermore, adding rituximab to cladribine leads to a higher response rate.

Keywords: Hairy cell leukemia; cladribine; purine analogue; rituximab.

MeSH terms

  • Antineoplastic Agents* / therapeutic use
  • Cladribine / adverse effects
  • Cladribine / therapeutic use
  • Follow-Up Studies
  • Humans
  • Iran / epidemiology
  • Leukemia, Hairy Cell* / diagnosis
  • Leukemia, Hairy Cell* / drug therapy
  • Leukemia, Hairy Cell* / epidemiology
  • Remission Induction
  • Rituximab / therapeutic use
  • Treatment Outcome

Substances

  • Cladribine
  • Antineoplastic Agents
  • Rituximab