Evolution of the therapy strategies in hairy cell leukemia — 22 years lasting case study

Abstract

Hairy cell leukemia (HCL) is a rare lymphoproliferative disease in which prognosis has improved markedly during last decades. Many authors indicated spectacular therapeutic effects of purine analogues, including cladribine and pentostatine. However, refractory or relapsing cases still could be observed. In this paper we present a case of adult patient with relapsing HCL who was treated with different therapeutic methods in the course of his disease. At the time of diagnosis in 1989, an infiltration of the bone marrow and peripheral blood, lymphadenopathy and splenomegaly were noted. After initial treatment with interferon alpha, splenectomy with subsequent prolonged administration of interferon alpha were used, with transient clinical response. Upon the progression of the disease, cladribine at a dose of 0,1 mg/kg daily on days 1–5 in every 4 weeks was administered and patient obtained complete remission (CR). Relapse was observed 16 years later when cladribine was used again with CR achievement. Taking into consideration the risk of another disease relapse in the future, possible therapeutic attitudes, including monoclonal antibodies, are discussed.
Hematologia 2011; 2, 3: 284–289