Difference between revisions of "Hairy cell leukemia"

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==Pentostatin (Nipent)==
 
==Pentostatin (Nipent)==
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===Regimen #1, Cassileth et al. 1991===
 
<span  
 
<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
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border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
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===regimen 1===
 
  
 
*[[Pentostatin (Nipent)]] 5 mg/m2 IV over 2 minutes once per day on days 1 & 2
 
*[[Pentostatin (Nipent)]] 5 mg/m2 IV over 2 minutes once per day on days 1 & 2
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'''14-day cycles, continued to the point of maximal response or treatment failure'''
 
'''14-day cycles, continued to the point of maximal response or treatment failure'''
  
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===regimen 2 IW Flinn et al 2000===
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===Regimen #2, Grever et al. 1995 & Flinn et al. 2000===
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<span  
 
<span  
 
style="background:#00CD00;
 
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border-style:solid;">Phase III</span>
 
border-style:solid;">Phase III</span>
  
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*Pentostatin 4 mg/m2 by rapid intravenous injection  
+
*[[Pentostatin (Nipent)]] 4 mg/m2 IV rapid injection once on day 1
 +
**Grever et al. 1995: Patients with performance status of 3 received an initial dose of [[Pentostatin (Nipent)]] 2 mg/m2 IV rapid injection once on day 1, which would be increased in later cycles to [[Pentostatin (Nipent)]] 4 mg/m2 IV rapid injection once on day 1 if patients had no adverse reactions.
 +
**Grever et al. 1995: Doses of pentostatin were held for patients who had an increase in the serum creatinine concentration >20% above their baseline.  Pentostatin was not given until renal function returned to baseline or if 24-hour creatinine clearance was >50 mL/min.
  
−
'''14 day cycles,patients who achieved a complete response before 6 months  given 2 additional doses of pentostatin 
+
Supportive medications (per Grever et al. 1995):
−
Patients with an objective partial response  can get further 6 months or until complete response or disease progression,
+
*1.5 liters of IV fluid hydration with every dose of pentostatin
−
The initial pentostatin dose could be reduced based on performance status and subsequent doses could be reduced based on renal function'''
 
  
−
supportive care: Patients who receive outpatient therapy with pentostatin are hydrated with 1.5 L of intravenous fluid with each dose of the drug. If an increase in the serum creatinine concentration is greater than 20% over the baseline, the dose is not administered until renal function returns to baseline.
+
'''14 day cycles'''; patients who had complete response before 6 months were given 2 additional cycles
 +
of pentostatin, and then treatment was stopped. Patients with objective partial response after 6 months of treatment received an additional 6 months of additional therapy, until they had a complete response or progression of disease.
  
 
===References===
 
===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]
 
# 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]
−
# Flinn IW, Kopecky KJ, Foucar MK, et al: Long-term follow-up of remission duration, mortality, and second malignancies in hairy cell leukemia patients treated with pentostatin. Blood 96: 2981-2986, 2000 [http://bloodjournal.hematologylibrary.org/content/96/9/2981.long link to original artcle ] [http://www.ncbi.nlm.nih.gov/pubmed?term=11049974 pubmed]
+
# Grever M, Kopecky K, Foucar MK, Head D, Bennett JM, Hutchison RE, Corbett WE, Cassileth PA, Habermann T, Golomb H, et al. Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia: an intergroup study. J Clin Oncol. 1995 Apr;13(4):974-82. [http://jco.ascopubs.org/content/13/4/974.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/7707126 PubMed]
−
# Grever M, Kopecky K, Foucar MK, et al. Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia: an intergroup study.[http://jco.ascopubs.org/content/13/4/974.long link to artcle] [http://www.ncbi.nlm.nih.gov/pubmed?term=7707126  pubmed ]
+
# Flinn IW, Kopecky KJ, Foucar MK, Head D, Bennett JM, Hutchison R, Corbett W, Cassileth P, Habermann T, Golomb H, Rai K, Eisenhauer E, Appelbaum F, Cheson B, Grever MR. Long-term follow-up of remission duration, mortality, and second malignancies in hairy cell leukemia patients treated with pentostatin. Blood. 2000 Nov 1;96(9):2981-6. [http://bloodjournal.hematologylibrary.org/content/96/9/2981.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/11049974 PubMed]
−
 
 
  
 
=Relapsed/Refractory=
 
=Relapsed/Refractory=

Revision as of 08:09, 22 April 2014

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Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.


Untreated

Cladribine (Leustatin)

Regimen #1, Tallman et al. 1996

Phase II

7-day course

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

Phase III

5-day course

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

Phase III

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

  1. 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
  2. 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
  3. 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
  4. 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
  5. 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

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

One course

References

  1. 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)

Regimen #1, Cassileth et al. 1991

Phase II

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

Regimen #2, Grever et al. 1995 & Flinn et al. 2000

Phase III

  • Pentostatin (Nipent) 4 mg/m2 IV rapid injection once on day 1
    • Grever et al. 1995: Patients with performance status of 3 received an initial dose of Pentostatin (Nipent) 2 mg/m2 IV rapid injection once on day 1, which would be increased in later cycles to Pentostatin (Nipent) 4 mg/m2 IV rapid injection once on day 1 if patients had no adverse reactions.
    • Grever et al. 1995: Doses of pentostatin were held for patients who had an increase in the serum creatinine concentration >20% above their baseline. Pentostatin was not given until renal function returned to baseline or if 24-hour creatinine clearance was >50 mL/min.

Supportive medications (per Grever et al. 1995):

  • 1.5 liters of IV fluid hydration with every dose of pentostatin

14 day cycles; patients who had complete response before 6 months were given 2 additional cycles of pentostatin, and then treatment was stopped. Patients with objective partial response after 6 months of treatment received an additional 6 months of additional therapy, until they had a complete response or progression of disease.

References

  1. 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
  2. Grever M, Kopecky K, Foucar MK, Head D, Bennett JM, Hutchison RE, Corbett WE, Cassileth PA, Habermann T, Golomb H, et al. Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia: an intergroup study. J Clin Oncol. 1995 Apr;13(4):974-82. link to original article contains verified protocol PubMed
  3. Flinn IW, Kopecky KJ, Foucar MK, Head D, Bennett JM, Hutchison R, Corbett W, Cassileth P, Habermann T, Golomb H, Rai K, Eisenhauer E, Appelbaum F, Cheson B, Grever MR. Long-term follow-up of remission duration, mortality, and second malignancies in hairy cell leukemia patients treated with pentostatin. Blood. 2000 Nov 1;96(9):2981-6. link to original article contains verified protocol PubMed

Relapsed/Refractory

BR

BR: Bendamustine, Rituximab

Regimen, Burotto et al. 2013

Pilot, <20 patients reported

28-day cycles x 6 cycles

References

  1. 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:

One 4-week course

References

  1. 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
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