Abstract:
:The purine analogs (PAs) cladribine and pentostatin have transformed the prognosis of hairy cell leukemia (HCL). However, some patients still relapse after PAs, or fail to reach an optimal response, and new agents are needed to further improve treatment outcome. We retrospectively studied 41 HCL patients from 10 centers in France and Belgium, who received 49 treatment courses with the anti-CD20 monoclonal antibody rituximab. Most of the patients were treated at relapse (84 % of cases) and rituximab was combined to a PA in 41 % of cases. Overall, response rate is 90 % including 71 % complete hematologic responses (CHRs). Frontline treatment, combination therapy, and absolute neutrophil count were associated with response in multivariate analysis. Three-year relapse-free and overall survivals are 68 and 90 %, respectively. When combined to a PA, rituximab yields a 100 % response rate, even beyond frontline therapy. In contrast, response rate is only 82 % (59 % CHR) when rituximab is used alone. In this latter setting, relapse rate is 56 % and median time to relapse is 17.5 months. All eight patients who were treated two times with the antibody responded again to re-treatment. We confirm the high efficacy of the combination rituximab + PA. However, when rituximab is used as monotherapy, response rate is lower and the high relapse rate is a concern. Prospective clinical trials are needed to confirm the superiority of the combination rituximab + PA over PA alone, both as frontline therapy and at relapse.
journal_name
Ann Hematoljournal_title
Annals of hematologyauthors
Leclerc M,Suarez F,Noël MP,Vekhoff A,Troussard X,Claisse JF,Thieblemont C,Maloisel F,Beguin Y,Tamburini J,Barbe C,Delmer Adoi
10.1007/s00277-014-2175-0subject
Has Abstractpub_date
2015-01-01 00:00:00pages
89-95issue
1eissn
0939-5555issn
1432-0584journal_volume
94pub_type
杂志文章,多中心研究abstract::In this retrospective study, we evaluated the clinical features and the effects of various treatment modalities on the clinical course in patients diagnosed with idiopathic thrombocytopenic purpura (ITP) at our center between 1984-2000. We retrospectively examined the medical records of 321 (229 females, 92 males) ITP...
journal_title:Annals of hematology
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journal_title:Annals of hematology
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journal_title:Annals of hematology
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journal_title:Annals of hematology
pub_type: 杂志文章
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journal_title:Annals of hematology
pub_type: 传,历史文章,杂志文章
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journal_title:Annals of hematology
pub_type: 临床试验,杂志文章
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journal_title:Annals of hematology
pub_type: 杂志文章
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journal_title:Annals of hematology
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journal_title:Annals of hematology
pub_type: 杂志文章
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journal_title:Annals of hematology
pub_type: 杂志文章
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journal_title:Annals of hematology
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journal_title:Annals of hematology
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pub_type: 指南,杂志文章,实务指引
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pub_type: 杂志文章,meta分析
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journal_title:Annals of hematology
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journal_title:Annals of hematology
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journal_title:Annals of hematology
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