Beyond hairy cell: the activity of cladribine in other hematologic malignancies.

Abstract:

:Before the contemporary development of rationally designed antineoplastic therapies, cladribine was identified as a lymphocyte-specific agent. Its profound impact on the natural history of hairy cell leukemia, with responses approaching 100% and a median duration of response of nearly a decade after only a single 7-day course, is well known and revolutionized the treatment of hairy cell leukemia. However, cladribine's impressive activity in other lymphoproliferative disorders has been generally underappreciated. Multiple single-arm phase 2 trials have demonstrated cladribine's potency across the full spectrum of lymphoid malignancies. In a limited number of phase 3 trials and cross-study analyses, cladribine compared favorably with fludarabine, another purine nucleoside analog that is more commonly used in the treatment of indolent lymphoid malignancies. Cladribine has been noted to have particular activity among lymphoid disorders with few effective therapies, specifically, chronic lymphocytic leukemia, lymphoplasmacytic lymphoma, marginal zone lymphoma, and mantle cell lymphoma. Recently approved novel agents may act in synergy with cladribine for these conditions and should be incorporated into future clinical studies.

journal_name

Blood

journal_title

Blood

authors

Sigal DS,Miller HJ,Schram ED,Saven A

doi

10.1182/blood-2010-02-246140

subject

Has Abstract

pub_date

2010-10-21 00:00:00

pages

2884-96

issue

16

eissn

0006-4971

issn

1528-0020

pii

blood-2010-02-246140

journal_volume

116

pub_type

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