Long-term follow-up of patients with hairy cell leukemia in the south of Iran

ABSTRACT

Background

Hairy cell leukemia (HCL) is an indolent chronic lymphoproliferative disorder and first-line treatment with either intravenous or subcutaneous cladribine generally leads to long-lasting remissions.

Method

All 131 patients with hairy-cell leukemia (HCL) were analyzed, with a median follow-up of 91 months. Data is from 2007 to 2020. We evaluated the response rate to cladribine as the first line and the response rate to cladribine with or without rituximab in relapsed patients. Further, we assessed relapse-free survival, complications, and secondary malignancy.

Results

After a median follow-up of 91 months, the recurrence rate was 24%. The 5-year and 10-year RFS rates were 85% and 66%, respectively. Adding rituximab to 2-CDA leads to a better response rate than just cladribine (90% vs. 27.3%, p-value = 0.002) in the relapsed patients.

Conclusion

HCL patients have long-term survival when cladribine is the first line of treatment. Furthermore, adding rituximab to cladribine leads to a higher response rate.

KEYWORDS:

• Hairy cell leukemia
• cladribine
• rituximab
• purine analogue

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethics and patient consent

Written informed consent for publication of their details was obtained from the patient/study participant/parent/guardian/next of kin. Human dignity and the preservation of medical secrets of individuals as well as the commitment to the Helsinki ethics have been observed during the study, and the handling of cases and confidential principles have been observed during the study.

Additional information

Funding

This paper was not funded.