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Blood, 1 July 2005, Vol. 106, No. 1, pp. 241-246.
Prepublished online as a Blood First Edition Paper on March 10, 2005; DOI 10.1182/blood-2005-01-0173.
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Submitted January 13, 2005
Accepted February 25, 2005
Treatment of hairy cell leukemia with 2-chlorodeoxyadenosine (2-CdA): long-term follow-up of the Northwestern University experience
Punit Chadha, Alfred W Rademaker, Prateek Mendiratta, Benjamin Kim, Darren M Evanchuk, David Hakimian, LoAnn C Peterson, and Martin S Tallman*
Division of Hematology/Oncology, Department of Medicine and Department of Pathology, Northwestern University Feinberg School of Medicine and Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
* Corresponding author; email: m-tallman{at}northwestern.edu.
2-chlorodeoxyadenosine (2-CdA), a purine analogue, has become universally accepted as the agent of choice in treating hairy cell leukemia (HCL). However, few studies have reported long-term outcomes after 2-CdA treatment. Between January 1990 and June 2003, 86 consecutive patients with HCL were treated with a single 7-day course of 2-CdA by continuous infusion at a dose of 0.1 mg/kg/day. Of the 86 patients (mean age: 49 years), 67 patients (79%) achieved a complete response (CR), 18 patients (21%) a partial response (PR), and 1 patient's response was unable to be assessed. The progression-free survival (PFS) for initial relapse after 12 years was 54%. At a median follow-up of 9.7 years (range: 0.3-13.8 years), 31/85 patients (36%) relapsed. Twenty-three relapsed patients were treated with a second cycle of 2-CdA, 2 patients with alternative agents, and 6 patients were observed. Of the 23 relapsed patients retreated with 2-CdA, 12 (52%) achieved a CR and 7 (30%) patients achieved a PR (overall response rate: 83%). The overall survival (OS) rate after 12 years was 87%. Fifteen patients (17%) developed other malignancies. Long-term follow-up of up 14 years (median of 9.7 years) showed an excellent PFS and OS for HCL patients after 2-CdA treatment.
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