Revision as of 14:20, 15 November 2013

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Untreated

Cladribine (Leustatin)

Regimen #1, Tallman et al. 1996

Phase II

Cladribine (Leustatin) 0.1 mg/kg/day IV continuous infusion on days 1 to 7 (total dose per cycle: 0.7 mg/kg)

7-day course

Regimen #2, Zenhäusern et al. 2009 (SAKK 32/98)

Phase III

Cladribine (Leustatin) 0.14 mg/kg/day IV continuous infusion on days 1 to 5 (total dose per cycle: 0.7 mg/kg)

5-day course

Regimen #3, Zenhäusern et al. 2009 (SAKK 32/98)

Phase III

Cladribine (Leustatin) 0.14 mg/kg/day IV once per day on days 1, 8, 15, 22, 29

5-week course

Regimen #4, Damasio et al. 1998

Phase II

Cladribine (Leustatin) 0.15 mg/kg IV over 2 hours once daily for 5 consecutive days

One course

Regimen #5, Robak et al. 1999

Phase II

Cladribine (Leustatin) 0.12 mg/kg IV over 2 hours once daily for 5 consecutive days

One course

References

Tallman MS, Hakimian D, Rademaker AW, Zanzig C, Wollins E, Rose E, Peterson LC. Relapse of hairy cell leukemia after 2-chlorodeoxyadenosine: long-term follow-up of the Northwestern University experience. Blood. 1996 Sep 15;88(6):1954-9. link to original article contains verified protocol PubMed
Update: Chadha P, Rademaker AW, Mendiratta P, Kim B, Evanchuk DM, Hakimian D, Peterson LC, Tallman MS. Treatment of hairy cell leukemia with 2-chlorodeoxyadenosine (2-CdA): long-term follow-up of the Northwestern University experience. Blood. 2005 Jul 1;106(1):241-6. Epub 2005 Mar 10. link to original article contains protocol PubMed content property of HemOnc.org
Zenhäusern R, Schmitz SF, Solenthaler M, Heim D, Meyer-Monard S, Hess U, Leoncini L, Bargetzi M, Rufener B, Tobler A. Randomized trial of daily versus weekly administration of 2-chlorodeoxyadenosine in patients with hairy cell leukemia: a multicenter phase III trial (SAKK 32/98). Leuk Lymphoma. 2009 Sep;50(9):1501-11. link to original article contains protocol PubMed
Damasio EE, Resegotti L, Masoudi B, et al: Five day intermittent vs seven day continuous 2′chlorodeoxyadenosine infusion for the treatment of hairy cell leukemia: A study by Italian Group for the Hairy Cell Leukemia. Recenti Prog Med 89:68-73, 1998
Robak T, Blasinska-Moraweic M, Blonski J, et al: 2′chlorodeoxyadenosine (caldribine) in the treatment of hairy cell leukemia and hairy cell leukemia variant: 7 year experience-Poland. Eur J Haematol 62:49-56, 1999

Cladribine & Rituximab

Regimen, Ravandi et al. 2011

Phase II

Cladribine (Leustatin) 5.6 mg/m2 IV 2 hours daily for 5 days

Supportive medications: All were administered at the discretion of the treating physician

28 days after administration of cladribine, bone marrow examination was repeated, and then rituximab was started

Rituximab (Rituxan) 375 mg/m2 IV weekly for 8 weeks

One course

References

Ravandi F, O'Brien S, Jorgensen J, Pierce S, Faderl S, Ferrajoli A, Koller C, Challagundla P, York S, Brandt M, Luthra R, Burger J, Thomas D, Keating M, Kantarjian H. Phase 2 study of cladribine followed by rituximab in patients with hairy cell leukemia. Blood. 2011 Oct 6;118(14):3818-23. link to original article contains verified protocol PubMed

Pentostatin (Nipent)

Phase II

Pentostatin (Nipent) 5 mg/m2 IV over 2 minutes once per day on days 1 & 2

14-day cycles, continued to the point of maximal response or treatment failure

References

Cassileth PA, Cheuvart B, Spiers AS, Harrington DP, Cummings FJ, Neiman RS, Bennett JM, O'Connell MJ. Pentostatin induces durable remissions in hairy cell leukemia. J Clin Oncol. 1991 Feb;9(2):243-6. link to original article contains protocol PubMed

Relapsed/Refractory

BR

BR: Bendamustine, Rituximab

Regimen, Burotto et al. 2013

Pilot, <20 patients reported

Rituximab (Rituxan) 375 mg/m2 IV once on days 1 & 15
Bendamustine (Treanda) 70 or 90 mg/m2 IV once daily on days 1 & 2

28-day cycles x 6 cycles

References

Burotto M, Stetler-Stevenson M, Arons E, Zhou H, Wilson W, Kreitman RJ. Bendamustine and Rituximab in Relapsed and Refractory Hairy Cell Leukemia. Clin Cancer Res. 2013 Oct 28. [Epub ahead of print] link to original article PubMed

Rituximab (Rituxan)

Regimen, Nieva et al. Blood 2003

Phase II

Rituximab (Rituxan) 375 mg/m2 IV weekly for 4 consecutive weeks
- Initial infusions were given at 50 mg per hour for the first 30 minutes, and if no toxicity was observed, the infusion rate was escalated at 30-minute intervals to a peak infusion rate of 300 mg per hour.

Supportive medications:

Allopurinol (Zyloprim) 300 mg PO once per day for the first 7 days of treatment

One 4-week course

References

Nieva J, Bethel K, Saven A. Phase 2 study of rituximab in the treatment of cladribine-failed patients with hairy cell leukemia. Blood. 2003 Aug 1;102(3):810-3. link to original article contains verified protocol PubMed

@@ Line 8: / Line 8: @@
 ==Cladribine (Leustatin)==
 ===Regimen #1, Tallman et al. 1996===
-Level of Evidence:
 <span
 style="background:#EEEE00;
@@ Line 21: / Line 20: @@
 ===Regimen #2, Zenhäusern et al. 2009 (SAKK 32/98)===
-Level of Evidence:
 <span
 style="background:#00CD00;
@@ Line 34: / Line 32: @@
 ===Regimen #3, Zenhäusern et al. 2009 (SAKK 32/98)===
-Level of Evidence:
 <span
 style="background:#00CD00;
@@ Line 46: / Line 43: @@
 '''5-week course'''
-== Regimen # 4 ==
+===Regimen #4, Damasio et al. 1998===
+<span
+style="background:#EEEE00;
+padding:3px 6px 3px 6px;
+border-color:black;
+border-width:2px;
+border-style:solid;">Phase II</span>
-Level of Evidence: Phase II
+Cladribine (Leustatin) 0.15 mg/kg IV over 2 hours once daily for 5 consecutive days
-Cladribine (Leustatin)  given over two hour i.v. infusion on 5 consecutive days (0.15 mg/kg/day)
+'''One course'''
-===== 2 hour infusion 5 day course =====
+===Regimen #5, Robak et al. 1999===
+<span
+style="background:#EEEE00;
+padding:3px 6px 3px 6px;
+border-color:black;
+border-width:2px;
+border-style:solid;">Phase II</span>
-== Regimen #5 ==
+Cladribine (Leustatin) 0.12 mg/kg IV over 2 hours once daily for 5 consecutive days
-Level of Evidence: Phase II
+'''One course'''
-Cladribine (Leustatin)  given as 2-h infusion for 5 consecutive days at a daily dose 0.12 mg/kg
-===== 2 hour infusion 5 day course =====
 ===References===
 # Tallman MS, Hakimian D, Rademaker AW, Zanzig C, Wollins E, Rose E, Peterson LC. Relapse of hairy cell leukemia after 2-chlorodeoxyadenosine: long-term follow-up of the Northwestern University experience. Blood. 1996 Sep 15;88(6):1954-9. [http://bloodjournal.hematologylibrary.org/content/88/6/1954.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/8822913 PubMed]
 # '''Update:''' Chadha P, Rademaker AW, Mendiratta P, Kim B, Evanchuk DM, Hakimian D, Peterson LC, Tallman MS. Treatment of hairy cell leukemia with 2-chlorodeoxyadenosine (2-CdA): long-term follow-up of the Northwestern University experience. Blood. 2005 Jul 1;106(1):241-6. Epub 2005 Mar 10. [http://bloodjournal.hematologylibrary.org/content/106/1/241.long link to original article] '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/15761021 PubMed] content property of [http://hemonc.org HemOnc.org]
-# Zenhäusern R, Schmitz SF, Solenthaler M, Heim D, Meyer-Monard S, Hess U, Leoncini L, Bargetzi M, Rufener B, Tobler A. Randomized trial of daily versus weekly administration of 2-chlorodeoxyadenosine in patients with hairy cell leukemia: a multicenter phase III trial (SAKK 32/98). Leuk Lymphoma. 2009 Sep;50(9):1501-11. doi: 10.1080/10428190903131755. [http://informahealthcare.com/doi/abs/10.1080/10428190903131755 link to original article] '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19672771 PubMed]
+# Zenhäusern R, Schmitz SF, Solenthaler M, Heim D, Meyer-Monard S, Hess U, Leoncini L, Bargetzi M, Rufener B, Tobler A. Randomized trial of daily versus weekly administration of 2-chlorodeoxyadenosine in patients with hairy cell leukemia: a multicenter phase III trial (SAKK 32/98). Leuk Lymphoma. 2009 Sep;50(9):1501-11. [http://informahealthcare.com/doi/abs/10.1080/10428190903131755 link to original article] '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19672771 PubMed]
 # Damasio EE, Resegotti L, Masoudi B, et al: Five day intermittent vs seven day continuous 2′chlorodeoxyadenosine infusion for the treatment of hairy cell leukemia: A study by Italian Group for the Hairy Cell Leukemia. Recenti Prog Med 89:68-73, 1998
 # Robak T, Blasinska-Moraweic M, Blonski J, et al: 2′chlorodeoxyadenosine (caldribine) in the treatment of hairy cell leukemia and hairy cell leukemia variant: 7 year experience-Poland. Eur J Haematol 62:49-56, 1999
 ==Cladribine & Rituximab==
 ===Regimen, Ravandi et al. 2011===
-Level of Evidence:
 <span
 style="background:#EEEE00;
@@ Line 84: / Line 84: @@
 *[[Cladribine (Leustatin)]] 5.6 mg/m2 IV 2 hours daily for 5 days
+Supportive medications:
+''All were administered at the discretion of the treating physician''
+*[[Levofloxacin (Levaquin)]]
+*[[Valcyclovir (Valcyte)]]
+*[[Fluconazole (Diflucan)]]
+*[[Filgrastim (Neupogen)]]
 '''28 days after administration of cladribine, bone marrow examination was repeated, and then rituximab was started'''
@@ Line 89: / Line 96: @@
 *[[Rituximab (Rituxan)]] 375 mg/m2 IV weekly for 8 weeks
-Supportive medications:
+'''One course'''
-''All were administered at the discretion of the treating physician''
-*Levofloxacin (Levaquin)
-*Valcyclovir (Valcyte)
-*Fluconazole (Diflucan)
-*Filgrastim (Neupogen)
 ===References===
@@ Line 100: / Line 102: @@
 ==Pentostatin (Nipent)==
-Level of Evidence:
 <span
 style="background:#EEEE00;
@@ Line 111: / Line 112: @@
 '''14-day cycles, continued to the point of maximal response or treatment failure'''
-Supportive medications:
 ===References===
 # Cassileth PA, Cheuvart B, Spiers AS, Harrington DP, Cummings FJ, Neiman RS, Bennett JM, O'Connell MJ. Pentostatin induces durable remissions in hairy cell leukemia. J Clin Oncol. 1991 Feb;9(2):243-6. [http://jco.ascopubs.org/content/9/2/243.long link to original article] '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/1988572 PubMed]
-=Relapsed=
+=Relapsed/Refractory=
 ==BR==
@@ Line 153: / Line 151: @@
 Supportive medications:
 *[[Allopurinol (Zyloprim)]] 300 mg PO once per day for the first 7 days of treatment
+'''One 4-week course'''
 ===References===
 # Nieva J, Bethel K, Saven A. Phase 2 study of rituximab in the treatment of cladribine-failed patients with hairy cell leukemia. Blood. 2003 Aug 1;102(3):810-3. [http://bloodjournal.hematologylibrary.org/content/102/3/810.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/12663446 PubMed]

Difference between revisions of "Hairy cell leukemia"

Revision as of 14:20, 15 November 2013

Contents

Untreated

Cladribine (Leustatin)

Regimen #1, Tallman et al. 1996

Regimen #2, Zenhäusern et al. 2009 (SAKK 32/98)

Regimen #3, Zenhäusern et al. 2009 (SAKK 32/98)

Regimen #4, Damasio et al. 1998

Regimen #5, Robak et al. 1999

References

Cladribine & Rituximab

Regimen, Ravandi et al. 2011

References

Pentostatin (Nipent)

References

Relapsed/Refractory

BR

Regimen, Burotto et al. 2013

References

Rituximab (Rituxan)

Regimen, Nieva et al. Blood 2003

References

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