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Long-term outcome with pentostatin treatment in hairy cell leukemia patients. A French retrospective study of 238 patients

Leukemia volume 17, pages 45–51 (2003)Cite this article

Abstract

With the introduction of new drugs such as alpha-interferon (IFN) and purine analogs, the management of hairy cell leukemia (HCL) patients has changed. However, deoxycoformycin (DCF) produced higher complete remission rates than IFN. The current study was undertaken to provide long-term data on duration of overall survival (OS) and disease-free survival (DFS) and incidence of subsequent malignancies. We retrospectively analyzed the data of patients treated with DCF (4 mg/m2/day, every 2 weeks) from 39 French centers. In 84 of 238 included patients, DCF was the first-line therapy. Pretreatment variables influencing the achievement of complete remission, DFS, and OS were identified by multivariate analysis. Two hundred and thirty-eight patients received a median of nine cycles (range, 1–19 cycles). A complete remission was obtained in 182 of 230 evaluable patients (79%) and a partial response was obtained in 38 patients, for an overall response rate of 95.6%. In the multivariate analysis hemoglobin level less than 100 g/l and leukocytes less than 2 × 109/l were parameters adversely influencing complete remission achievement. With a median follow-up of 63.5 months (range, 0.39–138.4 months), disease recurrence was observed in 34 of 220 responding patients (15%). The estimated 5-years and 10-years DFS was 88.1% and 68.8%, respectively. Hemoglobin level less than 100 g/l and leukocytes less than 2 × 109/l were the pre-treatment variables associated with a shorter DFS. The estimated 5-year and 10-year OS were 89.4% and 88.7%, respectively. Hemoglobin level less than 100 g/l, leukocytes less than 2 × 109/l, and adenopathy were significant factors of reduced survival. Hematologic toxicity was the main side-effect, followed by infection and emesis. During the period of follow-up, 18 patients developed second cancer, but the standardized incidence ratio was 0.95. Pentostatin is a highly effective regimen for hairy cell leukemia that produces durable complete responses. Toxicity of DCF is acceptable. Subsequent malignancies do not appear to be increased with pentostatin treatment.

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Acknowledgements

The following institutions (with main investigators) participated in the study: Hopital de l’Hotel-Dieu, Paris (Chauvenet L); Centre Hospitalier de Chalon s/Saone (Salles B, Baudet-Klepping S); Centre Hospitalier de Troyes (Dines G, Brahimi S); Centre Hospitalier du Nord Mayenne (Duquesnel F); Centre Hospitalier de Lorient (Moreau Ph); Centre Hospitalier d'Alençon (Frenkiel N); Hopital Percy Paris (Nedelec G, De Revel T); Centre Hospitalier de Colmar (Kohser F); HIA St Anne Toulon (de Jaureguiberry JP); Hopital ND du Bon Secours Metz (Christian B); Centre Hospitalier Le Mans (Dugay J); Centre Hospitalier Blois (Rodon Ph); Hopital Pontchalliou Rennes (Dauriac C); Centre Hospitalier Mulhouse (Eisenmann JC); Hopital Purpan Toulouse (Gaches F, Arlet-Suau E); CHU Lille (Noel MP, Bauters F); Clinique C Bernard Albi (Gaspard); Centre Hospitalier Béziers (David S); Centre Hospitalier Carcassonne (Vives JF); CHU Grenoble (Pegourie B); CHU Poitiers (Desmaret MC, Guilhot F); Hopital St Antoine Paris (Cheron N, Najman A); CHU Montpellier (Legouffe E); Hopital Purpan Toulouse (Schlaifer D, Payen C). We are indebted to Mrs Susan Dale who edited the manuscript and to I Cimarrosti who performed statistical analysis. This work was supported by a grant from Jansen-Cilag, France.

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Authors and Affiliations

  1. Département d'Hématologie et d'Oncologie, HUS, Strasbourg, France

    F Maloisel

  2. Service d'Oncologie Médicale et des Maladies du Sang, CHU, Tours, France

    L Benboubker

  3. Service des Maladies du Sang, CHU, Angers, France

    M Gardembas

  4. Service d'Hématologie, Clinique Centre Hospitalier Lyon Sud Pierre Benite, France

    B Coiffier

  5. Service d'Hématologie Hopital Henri Mondor, Creteil, France

    M Divine

  6. Service d'Hématologie Hopital Edouard Herriot, Lyon, France

    C Sebban

  7. Service de Médecine A7, Centre Hospitalier, Chambéry, France

    M Blanc

  8. Service d'Hématologie-Oncologie-Hémostase, Hopital Augustin Morvan, Brest, France

    J-F Abgrall

  9. Service de Médecine A, CHU Brabois, Nancy, France

    P Lederlin

  10. Service d'Hématologie, Clinique Hopital Hotel-Dieu, Nantes, France

    J-L Harousseau

  11. Département de Médecine Interne et d'Hématologie, Clinique Hopital Robert Debré, Reims, France

    A-M Blaise

  12. Service de Médecine G, CHRU Hopital Sud, Rennes, France

    B Grosbois

  13. Service d'Hématologie et d'Oncologie Médicale, Hopital Yves Le Foll, St Brieuc, France

    P Morice

  14. Cabinet d'Hématologie-Oncologie Polyclinique Sevigné, Rennes, France

    C Ghandour

  15. Service d'Hématologie et d'Oncologie, CH de Versailles, France

    S Castaigne

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  1. F Maloisel
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Correspondence to F Maloisel.

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Maloisel, F., Benboubker, L., Gardembas, M. et al. Long-term outcome with pentostatin treatment in hairy cell leukemia patients. A French retrospective study of 238 patients. Leukemia 17, 45–51 (2003). https://doi.org/10.1038/sj.leu.2402784

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  • DOI: https://doi.org/10.1038/sj.leu.2402784

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