Document 0769
 DOCN  M9590769
 TI    Response to interferon-alpha in patients with hairy cell leukemia
       relapsing after treatment with 2-chlorodeoxyadenosine.
 DT    9509
 AU    Seymour JF; Estey EH; Keating MJ; Kurzrock R; Department of Clinical
       Haematology and Medical Oncology, Royal; Melbourne Hospital, Australia.
 SO    Leukemia. 1995 May;9(5):929-32. Unique Identifier : AIDSLINE
       MED/95287665
 AB    2-Chlorodeoxyadenosine (2-CdA) has recently established itself as an
       extremely effective therapy for patients with hairy cell leukemia. To
       date, the issue of how to treat patients relapsing after 2-CdA has not
       been adequately addressed. In our initial study, 41 of 46 patients
       achieved an objective response (complete or partial remission). The only
       persistent toxicity associated with this agent appears to be significant
       suppression of CD4+ lymphocyte counts, albeit without evidence of
       clinical sequelae at a median follow-up of 30 months (range, 7-43).
       Eight patients have developed recurrent disease 3-23 months (median, 16
       months) after 2-CdA. Because of progressive cytopenias, three of these
       patients were treated with interferon-alpha (IFN-alpha) (3 x 10(6) units
       subcutaneously three times per week), commencing 2, 9 and 16 months
       after the documentation of relapse. All three patients have shown an
       objective response with reduction of marrow hairy cells and amelioration
       of neutropenia and thrombocytopenia (two patients, complete remission;
       one patient, partial remission). Responses were maintained while on
       IFN-alpha, but two patients relapsed shortly (3 and 4 months,
       respectively) after discontinuation of IFN. There was no significant
       toxicity. Prior to commencing IFN-alpha, 22-36 months after 2-CdA, these
       patients' absolute CD4+ counts were suppressed (mean 211/microliters,
       s.d. +/- 85/microliters), but have not significantly changed after 10,
       11 and 18 months of IFN-alpha therapy (mean 225/microliters, s.d. +/-
       93/microliters). These results suggest that in hairy cell leukemia
       patients relapsing after 2-CdA, IFN-alpha may be a reasonable
       therapeutic option, especially if persistent CD4+ lymphocytopenia is
       present.
 DE    Adult  Case Report  Cladribine/ADVERSE EFFECTS/*THERAPEUTIC USE
       Comparative Study  CD4 Lymphocyte Count  CD4-Positive
       T-Lymphocytes/CYTOLOGY/DRUG EFFECTS/IMMUNOLOGY  Follow-Up Studies  Human
       Interferon Alfa, Recombinant/*THERAPEUTIC USE  Leukemia, Hairy Cell/DRUG
       THERAPY/IMMUNOLOGY/*THERAPY  Male  Middle Age  T-Lymphocytopenia,
       Idiopathic CD4-Positive/CHEMICALLY INDUCED/  THERAPY  JOURNAL ARTICLE

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