Treatment for recurrent hairy cell leukemia.


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Abstract

Aim. To give data on the frequency of recurrent hairy cell leukemia (HCL) and to characterize the immediate and late results of its treatment in this group of patients. Materials and methods. The data on the frequency of recurrences were analyzed in 165 patients with HCL after remission achieved by the purine analogue cladribin in the period 1995 to 2011. The treatment of recurrent HCL included splenectomy, interferon-α, cladribin, and rituximab. Results. After a course of cladribin therapy, the total frequency of recurrent HCL was 22%. The high (47%) frequency of recurrences was found in young patients (less than 45 years) as compared to that (9%) in older patients. A combination of cladribin and rituximab showed a high efficacy in treating the early recurrence of HCL. Conclusion. The differences found in the frequency of recurrences give grounds to incorporate rituximab into the standard therapy regimen for HCL in young patients and in patients with early disease recurrence.

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Лечение рецидивов волосатоклеточного лейкоза. - Резюме. Цель исследования. Представить данные о частоте рецидивов волосатоклеточного лейкоза (ВКЛ), охарактеризовать непосредственные и отдаленные результаты лечения этой группы больных. Материалы и методы. Проанализированы данные о частоте рецидивов у 165 больных ВКЛ после ремиссии, достигнутой c помощью аналога пурина - кладрибина - в период с 1995 по 2011 г. Лечение в рецидиве включало спленэктомию, a-интерферон, кладрибин, ритуксимаб. Результаты. Общая частота рецидивов ВКЛ после курса терапии кладрибином составила 22%. Выявлена высокая частота рецидивов (47%) у пациентов молодого возраста (моложе 45 лет) по сравнению с 9% рецидивов у пациентов старшей возрастной группы. Показана большая эффективность сочетания кладрибина и ритуксимаба при раннем рецидиве ВКЛ. Заключение. Выявленные различия по частоте рецидивов дают основания для включения ритуксимаба в стандартную схему терапии ВКЛ у пациентов молодого возраста и у больных с ранним рецидивом заболевания.
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