Survival Experience of 195 Patients with Hairy Cell Leukemia Treated in a Multi-Institutional Study with
H M Golomb1, A Fefer1, D W Golde1
1a University of Chicago Medical Center, Chicago; University of Washington, Seattle; UCLA, Los Angeles; Roswell Park Memorial Institute, Buffalo, NY; Yale University, New Haven, CT; NYU, New York; Brigham & Women's Hospital, Boston; Schering Corporation, Kenilworth, NJ; and City of Hope National Medical Center, Duarte, CA, USA.
Abstract:
One hundred ninety-five patients were entered into a multi-institutional study of interferon alfa 2b from 1983-1986; follow-up was completed through June 1989. A complete remission was documented in 7 patients, a partial remission in 152 patients, a minor response in 10 patients, and no response in 26 patients. One-hundred fifty-nine of the 195 patients treated (81%) had a normalization of their peripheral blood counts by the criteria used. To date, 17 patients have died. Only 3 of the 159 patients (2%) with a PR or CR have expired. Three of 10 MR patients have expired and 11 of 26 NR patients have expired. Of the 11 who expired, 7 did so before receiving an adequate duration of treatment. Three of the NR patients died within 1 week of starting interferon from intracranial hemorrhages secondary to severe thrombocytopenia (present prior to initiation of interferon) and 4 NR patients died of infectious deaths within 2 months of initiating interferon therapy secondary to severe neutropenia (present prior to initiation of interferon). Of the 17 NR's who remained alive and on-study for at least 6 months, only 2 eventually died, both after failing subsequent pentostatin therapy. Systemic therapy with agents that induce a more rapid response such as pentostatin or 2-chlorodeoxy-adenosine, or the combination of interferon plus growth factor are indicated in these severely cytopenic patients.
