Cladribine in a weekly versus daily schedule for untreated active hairy cell leukemia: final report from the Polish Adult Leukemia Group (PALG) of a prospective, randomized, multicenter trial.
نویسندگان
چکیده
Cladribine (2-chlorodeoxyadenosine, 2-CdA) treatment-associated infections may shorten potentially long-term survival in hairy cell leukemia (HCL). In search of the optimal mode of 2-CdA administration, 132 patients with untreated HCL were randomized to receive either standard 5-day 2-CdA protocol or a novel schedule of 6 weekly 2-CdA infusions suggested to be less toxic. Analysis of treatment response confirmed similar complete remission rates, overall response rates, progression-free survival, and overall survival in both 2-CdA protocols. However, we did not observe lower toxicity in the weekly schedule. Of special interest, no significant differences were found in the rate of grade 3/4 infections (18% for daily and 26% for weekly protocol, difference -8.2%; 95% confidence interval [CI] -23.2% to 6.9%; P = .28) and the rate of septic deaths (3% for daily and 2% for weekly protocol, difference 1.4%; 95% CI -4.3% to 7.0%; P = .64). In conclusion, HCL treatment with weekly 2-CdA infusions is equally effective but no safer than the standard 5-day 2-CdA protocol.
منابع مشابه
Cladribine alone and in combination with cyclophosphamide or cyclophosphamide plus mitoxantrone in the treatment of progressive chronic lymphocytic leukemia: report of prospective, multicenter, randomized trial of the Polish Adult Leukemia Group (PALG CLL2)
Tadeusz Robak, Jerzy Z. Blonski, Joanna Gora-Tybor, Krzysztof Jamroziak, Jadwiga Dwilewicz-Trojaczek, Agnieszka Tomaszewska, Lech Konopka, Bernadetta Ceglarek, Anna Dmoszynska, Malgorzata Kowal, Janusz Kloczko, Beata Stella-Holowiecka, Kazimierz Sulek, Malgorzata Calbecka, Krystyna Zawilska, Kazimierz Kuliczkowski, Aleksander B. Skotnicki, Krzysztof Warzocha, Marek Kasznicki and the Polish Leuk...
متن کاملCLINICAL TRIALS AND OBSERVATIONS Cladribine alone and in combination with cyclophosphamide or cyclophosphamide plus mitoxantrone in the treatment of progressive chronic lymphocytic leukemia: report of a prospective, multicenter, randomized trial of the Polish Adult Leukemia Group (PALG CLL2)
Tadeusz Robak, Jerzy Z. Blonski, Joanna Gora-Tybor, Krzysztof Jamroziak, Jadwiga Dwilewicz-Trojaczek, Agnieszka Tomaszewska, Lech Konopka, Bernadetta Ceglarek, Anna Dmoszynska, Malgorzata Kowal, Janusz Kloczko, Beata Stella-Holowiecka, Kazimierz Sulek, Malgorzata Calbecka, Krystyna Zawilska, Kazimierz Kuliczkowski, Aleksander B. Skotnicki, Krzysztof Warzocha, Marek Kasznicki, and the Polish Leu...
متن کاملLong-term follow-up of front-line treatment of hairy cell leukemia with 2-chlorodeoxyadenosine.
BACKGROUND AND OBJECTIVES Although remission of hairy cell leukemia (HCL) after treatment with 2-chlorodeoxyadenosine (2-CdA) appears to be long lasting, few reports currently provide results from follow-up exceeding 5 years. DESIGN AND METHODS We reviewed our HCL patients treated with front-line 2-CdA (by 2-hour infusion) either for 5 consecutive days at 0.14 mg/kg/day (daily subset, n=21) o...
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The efficacy and toxicity of cladribine (2-CdA) + prednisone (P) versus chlorambucil (Chl) + P were compared in previously untreated patients with progressive or symptomatic chronic lymphocytic leukemia (CLL) in a randomized, multicenter prospective trial. Eligible patients were assigned to either 2-CdA 0.12 mg/kg per day in 2-hour infusions and P 30 mg/m(2) per day for 5 consecutive days or Ch...
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ورودعنوان ژورنال:
- Blood
دوره 109 9 شماره
صفحات -
تاریخ انتشار 2007