Cladribine Efficacy in a Patient with Hairy Cell Leukemia and Severe Renal Insufficiency

Hairy cell leukemia commonly presents with pancytopenia, indolent course, and predisposition as infectious complications. Current first-line therapeutic options are purine analogues, particularly cladribine, with a high percentage of complete responses and durable remissions. However, their use is poorly investigated in patients affected by severe chronic renal insufficiency.

Here, we describe a case of HCL in a 68-year-old man affected by multiple comorbidities, including severe chronic renal failure. After a course of interferon-α, the patient received therapy with Cladribine every other week, obtaining a complete hematological remission and improvement of renal function.

With a different soft schedule of cladribine, the patient was treated adequately, obtaining a complete remission.

Cladribine can be administered with caution, even in patients with renal failure, with good results.