Prospective long-term follow-up after first-line subcutaneous cladribine in hairy cell leukemia: a SAKK trial.

Details

Serval ID
serval:BIB_691BFBDC1C74
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prospective long-term follow-up after first-line subcutaneous cladribine in hairy cell leukemia: a SAKK trial.
Journal
Blood advances
Author(s)
Benz R., Arn K., Andres M., Pabst T., Baumann M., Novak U., Hitz F., Hess U., Zenhaeusern R., Chalandon Y., Mey U., Blum S., Rauch D., O'Meara Stern A., Cantoni N., Bargetzi M., Bianchi-Papina E., Rossi D., Passweg J., Lohri A., Berardi S., Li Q., Feller A., Stussi G.
ISSN
2473-9537 (Electronic)
ISSN-L
2473-9529
Publication state
Published
Issued date
11/08/2020
Peer-reviewed
Oui
Volume
4
Number
15
Pages
3699-3707
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Hairy cell leukemia (HCL) remains an incurable disease. However, first-line treatment with either intravenous or subcutaneous cladribine generally leads to long-lasting remissions. Although there are excellent long-term data for intravenous application, similar data regarding subcutaneous administration are lacking. We therefore analyzed the long-term outcome of 3 prospective multicenter clinical trials on subcutaneous cladribine performed by the Swiss Group for Clinical Cancer Research (SAKK), which recruited 221 patients with classical HCL between 1993 and 2005. Median overall survival from start of treatment was not reached. Pretreatment anemia, higher Eastern Cooperative Oncology Group score, and higher age were associated with poorer overall survival in multivariable analysis, whereas early progression at 24 and 36 months had no significant impact on overall survival. Second-line treatment was necessary in 53 (23.7%) patients after a median of 5 (range, 0.2-20.4) years, and first retreatment was mainly monotherapy with cladribine (66%) or rituximab (15.1%) or a combination of these drugs (15.1%). A total of 44 (19.9%) patients developed second primary malignancies with a median time to occurrence of 5.7 (range, 0.01-17.5) years. Second primary malignancies were the main cause for death (14; 27.5%). Compared with a matched normal Swiss population, the incidence of second primary malignancies was not increased. However, survival of patients with HCL was slightly inferior by comparison (P = .036). In conclusion, the outcome of HCL patients treated with subcutaneous cladribine is excellent, and in most patients, 1 cycle of subcutaneous cladribine is sufficient for long-term disease control.
Pubmed
Open Access
Yes
Create date
17/08/2020 10:28
Last modification date
25/08/2020 6:26
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