Retrospective evaluation of hairy cell leukemia patients; Analysis of a long-term single center data
-
Mohammad Biglari
,
Hosein Kamranzadeh Foumani
,
Maryam Bagherian
,
Bahram Chahardouli
,
Ardeshir Ghavamzadeh
Abstract
Background: Hairy cell leukemia (HCL) is a distinct lymphoproliferative disorder with unique circulating lymphocyte morphology. It is now regarded as an indolent disease yet treatable with purine analogs. We are going to present a complete long-term clinical and prognostic report of our HCL patients as a large cohort in Iran.
Methods: All patients diagnosed with HCL according to WHO criteria referred to our academic center in the period of 1995 to 2020 are enrolled. Treatment with daily cladribine regimen was initiated as indicated and patients were followed. Survival data and clinical outcome of patients were calculated.
Results: A total 50 patients were studied (76% male). Median time to treatment was 4.8 months and complete remission was achieved in 92% of patients. Nine patients (18%) experienced relapse with median time to relapse of 47 months. After median follow-up of 51 months, the median OS was not reached and after 234 months, the overall survival rate was 86%. Survival was worse in patients with non-classic HCL (vHCL) compared to classic HCL.
Conclusion: Our long-term follow up data confirmed favorable outcome of Iranian HCL patients with cladribine and provide a useful viewpoint of the disease.
1. Tadmor T, Polliack A. Epidemiology and environmental risk in hairy cell leukemia. Best Pract. Res. Clin. Haematol. 2015; 28: 175–179.
2. Catovsky D. Hairy cell leukemia and prolymphocytic leukemia. Clin Haematol. 1977; 6: 245–68.
3. Golomb HM, Catovsky D, Golde DW. Hairy cell leukemia: a clinical review based on 71 cases. Ann Intern Med. 1978; 89: 677–83.
4. Ruiz-Delgado GJ, Tarín-Arzaga LC, Alarcón-Urdaneta C, Calderón-García J, Gómez-Almaguer D, Ruiz-Argüelles GJ. Treatment of hairy cell eukemia: long-term results in a developing country. Hematology. 2012; 17 (3): 140-143.
5. Inbar M, Herishanu Y, Goldschmidt N, Bairey O, Yuklea M, Shvidel L, Fineman R, Aviv A, Ruchlemer R, Braester A, Najib D, Rouvio O, Shaulov A, Greenbaum U, Polliack A, Tadmor T. Hairy Cell Leukemia: Retrospective Analysis of Demographic Data and Outcome of 203 Patients from 12 Medical Centers in Israel. Anticancer research . 2018; 38: 6423-6429.
6. Hacioglu S, Bilen Y, Eser A, Sivgin S, Gurkan E, Yildirim R, Aydogdu I, Dogu MH, Yilmaz M, Kayikci O, Tombak A, Kuku I, Celebi H, Akay MO, Esen R, Korkmaz S, Keskin A. Multicenter retrospective analysis regarding the clinical manifestations and treatment results in patients with hairy cell leukemia: twenty-four year Turkish experience in cladribine therapy. Hematol Oncol. 2015 Dec; 33 (4): 192-8.
7. Maevis V, Mey U, Schmidt-Wolf G, Schmidt-Wolf IG. Hairy cell leukemia: short review, today's recommendations and outlook. Blood Cancer J. 2014 Feb ; 4 (2): e184
8. Golomb HM, Jacobs A, Fefer A, Ozer H, Thompson J, Portlock C, et al. Alpha-2-interferon therapy of hairy cell leukemia: a multicenter study of 64 patients. J Clin Oncol. 1986; 4: 900–5.
9. Benz R, Siciliano RD, Stussi G, Fehr J. Long term follow up of interferon alpha induction and low dose maintenance therapy in hairy cell leukemia. Eur J Haematol. 2009; 82: 194–200.
10. Dearden CE, Else M and Catovsky D: Long-term results for pentostatin and cladribine treatment of hairy cell leukemia. Leuk Lymphoma. 2011; 52 (Suppl 2): 21-24.
11. Else M, Ruchlemer R, Osuji N, Del Giudice I, Matutes E, Woodman A, Wotherspoon A, Swansbury J, Dearden C and Catovsky D: Long remissions in hairy cell leukemia with purine analogs: a report of 219 patients with a median follow-up of 12.5 years. Cancer. 2005; 104 (11): 2442-2448.
12. Foucar K FB, Catovsky D and Stein H: Hairy Cell Leukaemia. In: WHO Classification of Tumours of the Haematopoietic and Lymphoid Tissues (4th edn), Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW (eds). IARC Press: Lyon, 2008; 188-190.
13. Grever MR, Abdel-Wahab O, Andritsos LA, Banerji V, Barrientos J, Blachly JS, Call TG, Catovsky D, Dearden C, Demeter J, Else M, Forconi F, Gozzetti A, Ho AD, Johnston JB, Jones J, Juliusson G, Kraut E, Kreitman RJ, Larratt L, Lauria F, Lozanski G, Montserrat E, Parikh SA, Park JH, Polliack A, Quest GR, Rai KR, Ravandi F, Robak T, Saven A, Seymour JF, Tadmor T, Tallman MS, Tam C, Tiacci E, Troussard X, Zent CS, Zenz T, Zinzani PL and Falini B: Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia. Blood. 2017; 129 (5): 553-560.
14. Bernstein L, Newton P, Ross RK. Epidemiology of hairy cell leukemia in Los Angeles County. Cancer Res. 1990 Jun; 50 (12): 3605-9.
15. Matutes E. Immunophenotyping and differential diagnosis of hairy cell leukemia. Hematol Oncol Clin North Am. 2006; 20: 1051–63.
16. Tiacci E, Trifonov V, Schiavoni G, Holmes A, Kern W, Martelli MP, Pucciarini A, Bigerna B, Pacini R, Wells VA, Sportoletti P, Pettirossi V, Mannucci R, Elliott O, Liso A, Ambrosetti A, Pulsoni A, Forconi F, Trentin L, Semenzato G, Inghirami G, Capponi M, Di Raimondo F, Patti C, Arcaini L, Musto P, Pileri S, Haferlach C, Schnittger S, Pizzolo G, Foà R, Farinelli L, Haferlach T, Pasqualucci L, Rabadan R and Falini B: BRAF mutations in hairy-cell leukemia. N Engl J Med. 2011. 16; 364 (24): 2305-2315.
17. Else M, Dearden CE, Matutes E, Garcia-Talavera J, Rohatiner AZ, Johnson SA, O'Connor NT, Haynes A, Osuji N, Forconi F, Lauria F, Catovsky D. Long-term follow-up of 233 patients with hairy cell leukaemia, treated initially with pentostatin or cladribine, at a median of 16 years from diagnosis. Br J Haematol. 2009;145 (6): 733-40.
18. Saven A, Burian C, Koziol JA, Piro LD. Long-term follow-up of patients with hairy cell leukemia after cladribine treatment. Blood. 1998. 15; 92 (6): 1918-26.
19. Goodman GR, Burian C, Koziol JA, Saven A. Extended follow-up of patients with hairy cell leukemia after treatment with cladribine. J Clin Oncol. 2003. 1; 21 (5): 891-6.
20. Hoffman MA, Janson D, Rose E, Rai KR: Treatment of hairy cell leukemia with cladribine: Response, toxicity and long-term follow-up. J Clin Oncol. 1997; 15: 1138.
21. Kraut EH, Grever MR, Bouroncle BA: Long-term follow-up of patients with hairy cell leukemia after treatment with 28-deoxycoformycin. Blood. 1994; 84: 4061.
22. Spurgeon S, Yu M, Phillips JD, Epner EM. Cladribine: not just another purine analogue? Expert Opin Investig Drugs. 2009; 18 (8): 1169-81.
23. Rosenberg JD, Burian C, Waalen J and Saven A: Clinical characteristics and long-term outcome of young hairy cell leukemia patients treated with cladribine; a single-institution series. Blood. 2014. 9; 123 (2): 177-183.
24. Getta MB, Woo KM, Devlin S, Park JH, Abdel-Wahab O, Saven A, Rai K and Tallman MS: Treatment outcomes and secondary cancer incidence in young patients with hairy cell leukaemia; Br J Haematol. 2016; 175 (3): 402-409.
25. Saven A, Piro LD. Complete remissions in hairy cell leukemia with 2-chlorodeoxyadenosine after failure with 2’- deoxycoformycin. Ann Intern Med. 1993. 15; 119 (4): 278-283.
26. Catovsky D, Matutes E, Talavera JG, O’Connor NT, Johnson SA, Emmett E, Corbett L and Swansbury J: Long term results with 2-deoxycoformycin in hairy cell leukemia. Leuk Lymphoma. 14 (Suppl 1): 109-113.
27. Paillassa J, Cornet E, Noel S, Tomowiak C, Lepretre S, Vaudaux S, Dupuis J, Devidas A, Joly B, Petitdidier-Lionnet C, Haiat S, Mariette C, Thieblemont C, Decaudin D, Validire-Charpy P, Drenou B, Eisenmann JC, Uribe MO, Olivrie A, Touati M, Lambotte O, Hermine O, Karsenti JM, Feugier P, Vaillant W, Gutnecht J, Lippert E, Huysman F, Ghomari K, Boubaya M, Levy V, Riou J, Damaj G, Tanguy-Schmidt A, Hunault-Berger M, Troussard X. Analysis of a cohort of 279 patients with hairy-cell leukemia (HCL): 10 years of follow-up. Blood Cancer J. 2020 May; 10 (5): 62.
28. Maloisel F, Benboubker L, Gardembas M, Coiffier B, Divine M, Sebban C, Blanc M, Abgrall JF, Lederlin P, Harousseau JL, Blaise AM, Grosbois B, Morice P, Ghandour C, Castaigne S. Long-term outcome with pentostatin treatment in hairy cell leukemia patients. A French retrospective study of 238 patients. Leukemia. 2003; 17 (1): 45-51.
29. 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; 96 (9): 2981-6
30. Mercieca J, Matutes E, Emmett E, Coles H, Catovsky D. 2-Chlorodeoxyadenosine in the treatment of hairy cell leukaemia: differences in response in patients with and without abdominal lymphadenopathy. Br J Haematol. 1996 May; 93 (2): 409-11.
31. Ruco LP, Procopio A, Maccallini V, Calogero A, Uccini S, Annino L, Mandelli F, Baroni CD. Severe deficiency of natural killer activity in the peripheral blood of patients with hairy cell leukemia. Blood. 1983; 61 (6): 1132-7.
32. Cheson BD, Vena DA, Barrett J, Freidlin B. Second malignancies as a consequence of nucleoside analog therapy for chronic lymphoid leukemias. J Clin Oncol. 1999; 17 (8): 2454-60. doi: 10.1200/JCO.1999.17.8.2454. PMID: 10561309.
33. Seymour JF, Kurzrock R, Freireich EJ, Estey EH. 2-chlorodeoxyadenosine induces durable remissions and prolonged suppression of CD4+ lymphocyte counts in patients with hairy cell leukemia. Blood. 1994.15; 83 (10): 2906-11.
34. Găman, A. M. Hairy cell leukemia-a rare type of leukemia. A retrospective study on 39 patients. Rom. J. Morphol. Embryol. 2018; 54, 575–579.
35. Else, M., Dearden, C. E. & Catovsky, D. Long-term follow-up after purine analogue therapy in hairy cell leukaemia. Best Pract. Res. Clin. Haematol. 2009; 28, 217–229.
36. Watts, J. M. et al. Melanoma and non-melanoma skin cancers in hairy cell leukaemia: a surveillance, epidemiology and end results population analysis and the 30-year experience at memorial sloan kettering cancer center. Br. J.Haematol. 2015; 171, 84–90.
2. Catovsky D. Hairy cell leukemia and prolymphocytic leukemia. Clin Haematol. 1977; 6: 245–68.
3. Golomb HM, Catovsky D, Golde DW. Hairy cell leukemia: a clinical review based on 71 cases. Ann Intern Med. 1978; 89: 677–83.
4. Ruiz-Delgado GJ, Tarín-Arzaga LC, Alarcón-Urdaneta C, Calderón-García J, Gómez-Almaguer D, Ruiz-Argüelles GJ. Treatment of hairy cell eukemia: long-term results in a developing country. Hematology. 2012; 17 (3): 140-143.
5. Inbar M, Herishanu Y, Goldschmidt N, Bairey O, Yuklea M, Shvidel L, Fineman R, Aviv A, Ruchlemer R, Braester A, Najib D, Rouvio O, Shaulov A, Greenbaum U, Polliack A, Tadmor T. Hairy Cell Leukemia: Retrospective Analysis of Demographic Data and Outcome of 203 Patients from 12 Medical Centers in Israel. Anticancer research . 2018; 38: 6423-6429.
6. Hacioglu S, Bilen Y, Eser A, Sivgin S, Gurkan E, Yildirim R, Aydogdu I, Dogu MH, Yilmaz M, Kayikci O, Tombak A, Kuku I, Celebi H, Akay MO, Esen R, Korkmaz S, Keskin A. Multicenter retrospective analysis regarding the clinical manifestations and treatment results in patients with hairy cell leukemia: twenty-four year Turkish experience in cladribine therapy. Hematol Oncol. 2015 Dec; 33 (4): 192-8.
7. Maevis V, Mey U, Schmidt-Wolf G, Schmidt-Wolf IG. Hairy cell leukemia: short review, today's recommendations and outlook. Blood Cancer J. 2014 Feb ; 4 (2): e184
8. Golomb HM, Jacobs A, Fefer A, Ozer H, Thompson J, Portlock C, et al. Alpha-2-interferon therapy of hairy cell leukemia: a multicenter study of 64 patients. J Clin Oncol. 1986; 4: 900–5.
9. Benz R, Siciliano RD, Stussi G, Fehr J. Long term follow up of interferon alpha induction and low dose maintenance therapy in hairy cell leukemia. Eur J Haematol. 2009; 82: 194–200.
10. Dearden CE, Else M and Catovsky D: Long-term results for pentostatin and cladribine treatment of hairy cell leukemia. Leuk Lymphoma. 2011; 52 (Suppl 2): 21-24.
11. Else M, Ruchlemer R, Osuji N, Del Giudice I, Matutes E, Woodman A, Wotherspoon A, Swansbury J, Dearden C and Catovsky D: Long remissions in hairy cell leukemia with purine analogs: a report of 219 patients with a median follow-up of 12.5 years. Cancer. 2005; 104 (11): 2442-2448.
12. Foucar K FB, Catovsky D and Stein H: Hairy Cell Leukaemia. In: WHO Classification of Tumours of the Haematopoietic and Lymphoid Tissues (4th edn), Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW (eds). IARC Press: Lyon, 2008; 188-190.
13. Grever MR, Abdel-Wahab O, Andritsos LA, Banerji V, Barrientos J, Blachly JS, Call TG, Catovsky D, Dearden C, Demeter J, Else M, Forconi F, Gozzetti A, Ho AD, Johnston JB, Jones J, Juliusson G, Kraut E, Kreitman RJ, Larratt L, Lauria F, Lozanski G, Montserrat E, Parikh SA, Park JH, Polliack A, Quest GR, Rai KR, Ravandi F, Robak T, Saven A, Seymour JF, Tadmor T, Tallman MS, Tam C, Tiacci E, Troussard X, Zent CS, Zenz T, Zinzani PL and Falini B: Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia. Blood. 2017; 129 (5): 553-560.
14. Bernstein L, Newton P, Ross RK. Epidemiology of hairy cell leukemia in Los Angeles County. Cancer Res. 1990 Jun; 50 (12): 3605-9.
15. Matutes E. Immunophenotyping and differential diagnosis of hairy cell leukemia. Hematol Oncol Clin North Am. 2006; 20: 1051–63.
16. Tiacci E, Trifonov V, Schiavoni G, Holmes A, Kern W, Martelli MP, Pucciarini A, Bigerna B, Pacini R, Wells VA, Sportoletti P, Pettirossi V, Mannucci R, Elliott O, Liso A, Ambrosetti A, Pulsoni A, Forconi F, Trentin L, Semenzato G, Inghirami G, Capponi M, Di Raimondo F, Patti C, Arcaini L, Musto P, Pileri S, Haferlach C, Schnittger S, Pizzolo G, Foà R, Farinelli L, Haferlach T, Pasqualucci L, Rabadan R and Falini B: BRAF mutations in hairy-cell leukemia. N Engl J Med. 2011. 16; 364 (24): 2305-2315.
17. Else M, Dearden CE, Matutes E, Garcia-Talavera J, Rohatiner AZ, Johnson SA, O'Connor NT, Haynes A, Osuji N, Forconi F, Lauria F, Catovsky D. Long-term follow-up of 233 patients with hairy cell leukaemia, treated initially with pentostatin or cladribine, at a median of 16 years from diagnosis. Br J Haematol. 2009;145 (6): 733-40.
18. Saven A, Burian C, Koziol JA, Piro LD. Long-term follow-up of patients with hairy cell leukemia after cladribine treatment. Blood. 1998. 15; 92 (6): 1918-26.
19. Goodman GR, Burian C, Koziol JA, Saven A. Extended follow-up of patients with hairy cell leukemia after treatment with cladribine. J Clin Oncol. 2003. 1; 21 (5): 891-6.
20. Hoffman MA, Janson D, Rose E, Rai KR: Treatment of hairy cell leukemia with cladribine: Response, toxicity and long-term follow-up. J Clin Oncol. 1997; 15: 1138.
21. Kraut EH, Grever MR, Bouroncle BA: Long-term follow-up of patients with hairy cell leukemia after treatment with 28-deoxycoformycin. Blood. 1994; 84: 4061.
22. Spurgeon S, Yu M, Phillips JD, Epner EM. Cladribine: not just another purine analogue? Expert Opin Investig Drugs. 2009; 18 (8): 1169-81.
23. Rosenberg JD, Burian C, Waalen J and Saven A: Clinical characteristics and long-term outcome of young hairy cell leukemia patients treated with cladribine; a single-institution series. Blood. 2014. 9; 123 (2): 177-183.
24. Getta MB, Woo KM, Devlin S, Park JH, Abdel-Wahab O, Saven A, Rai K and Tallman MS: Treatment outcomes and secondary cancer incidence in young patients with hairy cell leukaemia; Br J Haematol. 2016; 175 (3): 402-409.
25. Saven A, Piro LD. Complete remissions in hairy cell leukemia with 2-chlorodeoxyadenosine after failure with 2’- deoxycoformycin. Ann Intern Med. 1993. 15; 119 (4): 278-283.
26. Catovsky D, Matutes E, Talavera JG, O’Connor NT, Johnson SA, Emmett E, Corbett L and Swansbury J: Long term results with 2-deoxycoformycin in hairy cell leukemia. Leuk Lymphoma. 14 (Suppl 1): 109-113.
27. Paillassa J, Cornet E, Noel S, Tomowiak C, Lepretre S, Vaudaux S, Dupuis J, Devidas A, Joly B, Petitdidier-Lionnet C, Haiat S, Mariette C, Thieblemont C, Decaudin D, Validire-Charpy P, Drenou B, Eisenmann JC, Uribe MO, Olivrie A, Touati M, Lambotte O, Hermine O, Karsenti JM, Feugier P, Vaillant W, Gutnecht J, Lippert E, Huysman F, Ghomari K, Boubaya M, Levy V, Riou J, Damaj G, Tanguy-Schmidt A, Hunault-Berger M, Troussard X. Analysis of a cohort of 279 patients with hairy-cell leukemia (HCL): 10 years of follow-up. Blood Cancer J. 2020 May; 10 (5): 62.
28. Maloisel F, Benboubker L, Gardembas M, Coiffier B, Divine M, Sebban C, Blanc M, Abgrall JF, Lederlin P, Harousseau JL, Blaise AM, Grosbois B, Morice P, Ghandour C, Castaigne S. Long-term outcome with pentostatin treatment in hairy cell leukemia patients. A French retrospective study of 238 patients. Leukemia. 2003; 17 (1): 45-51.
29. 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; 96 (9): 2981-6
30. Mercieca J, Matutes E, Emmett E, Coles H, Catovsky D. 2-Chlorodeoxyadenosine in the treatment of hairy cell leukaemia: differences in response in patients with and without abdominal lymphadenopathy. Br J Haematol. 1996 May; 93 (2): 409-11.
31. Ruco LP, Procopio A, Maccallini V, Calogero A, Uccini S, Annino L, Mandelli F, Baroni CD. Severe deficiency of natural killer activity in the peripheral blood of patients with hairy cell leukemia. Blood. 1983; 61 (6): 1132-7.
32. Cheson BD, Vena DA, Barrett J, Freidlin B. Second malignancies as a consequence of nucleoside analog therapy for chronic lymphoid leukemias. J Clin Oncol. 1999; 17 (8): 2454-60. doi: 10.1200/JCO.1999.17.8.2454. PMID: 10561309.
33. Seymour JF, Kurzrock R, Freireich EJ, Estey EH. 2-chlorodeoxyadenosine induces durable remissions and prolonged suppression of CD4+ lymphocyte counts in patients with hairy cell leukemia. Blood. 1994.15; 83 (10): 2906-11.
34. Găman, A. M. Hairy cell leukemia-a rare type of leukemia. A retrospective study on 39 patients. Rom. J. Morphol. Embryol. 2018; 54, 575–579.
35. Else, M., Dearden, C. E. & Catovsky, D. Long-term follow-up after purine analogue therapy in hairy cell leukaemia. Best Pract. Res. Clin. Haematol. 2009; 28, 217–229.
36. Watts, J. M. et al. Melanoma and non-melanoma skin cancers in hairy cell leukaemia: a surveillance, epidemiology and end results population analysis and the 30-year experience at memorial sloan kettering cancer center. Br. J.Haematol. 2015; 171, 84–90.
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| Issue | Vol 16, No 4 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijhoscr.v16i4.10878 | |
| Keywords | ||
| Hairy Cell Leukemia Leukemia Survival Nucleoside analog | ||
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How to Cite
1.
Biglari M, Kamranzadeh Foumani H, Bagherian M, Chahardouli B, Ghavamzadeh A. Retrospective evaluation of hairy cell leukemia patients; Analysis of a long-term single center data. Int J Hematol Oncol Stem Cell Res. 2022;16(4):209-216.
