68
M. S. Tallman
gate, reduces the tumor burden sufficiently that minimal residual hairy cells do not produce sufficient amounts of suppressive cytokines to inhibit normal hematopoiesis [18]. However, the latter is specula- tion, and further studies may provide the answer, which is difficult to predict given the often very long natural history of HCL.
Summary
Hairy cell leukemia generally has an indolent clinical course. While the majority of patients have a very favorable outcome with current therapies, it is clear that the disease is not often, if ever, curable. Minimal residual disease after otherwise effective therapy with purine analogs can be detected by a variety of techniques. However, prospective studies will be required to establish whether pre-emptive therapy for MRD before morphologic disease becomes evident is beneficial for patients and improves overall survival. Such studies may become less important if novel strategies including the monoclonal antibody ritux- imab [19] or the immunoconjugate BL22 [20] fulfill their promise in previously untreated patients. If they are as effective in this setting as they are in relapsed and refractory patients, there may be less MRD to detect.
Acknowledgement
The author acknowledges the assistance of Dr. Cyrus Hedvat with the figure legends.
Potential conflict of interest: A disclosure form provided by the author is available with the full text of this article at
www.informahealthcare.com/lal.
References
1. Chadha P, Rademaker AW, Mendiratta P, et al. Treatment of hairy cell leukemia with 2-chlorodeoxyadenosine (2-CdA): long-term follow-up of the Northwestern University experi- ence. Blood 2005;106:241–246.
2. Else M, Ruchlemer R, Osuji N, et al. 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;104:2242– 2248.
3. 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;21:891–896.
4. Sigal DS, Sharpe R, Burian C, Saven A. Very long-term eradication of minimal residual disease in patients with hairy cell leukemia after a single course of cladribine. Blood 2010;115:1893–1896.
5. Tallman MS, Hakimian D, Kopecky KJ, et al. Minimal residual disease in patients with hairy cell leukemia in complete remission treated with 2-chlorodeoxyadenosine or 2-deoxycoformycin and prediction of early relapse. Clin Cancer Res 1999;5:1665–1670.
6. Hakimian D, Tallman MS, Kiley C, Peterson L. Detection of minimal residual disease by immunostaining of bone marrow biopsies after 2-chlorodeoxyadenosine for hairy cell leukemia. Blood 1993;82:1798–1802.
7. Arons E, Margulies I, Sorbara L, et al. Minimal residual disease in hairy cell leukemia patients assessed by clone- specific polymerase chain reaction. Clin Cancer Res 2006;12:2804–2811.
8. Filleul B, Delannoy A, Ferrant A, et al. A single course of 2- chlorodeoxyadenosine does not eradicate leukemic cells in hairy cell leukemia patients in complete remission. Leukemia 1994;8:1153–1156.
9. Chen YH, Tallman MS, Goolsby C, Peterson L. Immuno- phenotypic variations in hairy cell leukemia. Am J Clin Pathol 2006;125:251–259.
10. Bengio R, Narbaitz MI, Sarmiento MA, et al. Comparative analysis of immunophenotypic methods for the assessment of minimal residual disease in hairy cell leukemia. Haematologica 2000;85:1227–1229.
11. Sausville JE, Salloum R, Sorbara L, et al. Minimal residual disease detection in hairy cell leukemia. Comparison of flow cytometric immunophenotyping with clonal analysis using consensus primer polymerase chain reaction for the heavy chain gene. Am J Clin Pathol 2003;119:213–217.
12. Wheaton S, Tallman MS, Hakimian D, Peterson LC. Minimal residual disease may predict bone marrow relapse in patients with hairy cell leukemia treated with 2-chlorodeox- yadenosine. Blood 1996;87:1556–1560.
13. Bastie JN, Cazals-Hatem D, Daniel MT, et al. Five years follow-up after 2-chloro deoxyadenosine treatment in thirty patients with hairy cell leukemia: evaluation of minimal
residual disease and CD4þ lymphocytopenia after treatment. Leuk Lymphoma 1999;35:555–565.
14. Mhawech-Fauceglia P, Overholzer M, Aschenafi S, et al. Potential predictive patterns of minimal residual disease detected by immunohistochemistry on bone marrow biopsy specimens during a long-term follow-up in patients treated with cladribine for hairy cell leukemia. Arch Pathol Lab Med 2006;130:374–377.
15. Ravandi F, Jorgensen JL, O’Brien SM, et al. Eradication of minimal residual disease in hairy cell leukemia. Blood 2006;107:4658–4662.
16. Cervetti G, Galimberti S, Andreazzoli F, et al. Rituximab as treatment for minimal residual disease in hairy cell leukaemia. Eur J Haematol 2004;73:412–417.
17. Golomb HM, Vardiman JW. Response to splenectomy in 65 patients with hairy cell leukemia: an evaluation of spleen weight and bone marrow involvement. Blood 1983;61:349–352.
18. Taniguchi N, Kuratsuna H, Kanamaru A, et al. Inhibition against CFU-C and CFU-E colony formation by soluble factor(s) derived from hairy cells. Blood 1989;73:907–913.
19. Else M, Osuji N, Forconi F, et al. The role of rituximab in combination with pentostatin or cladribine for the treatment of recurrent/refractory hairy cell leukemia. Cancer 2007;110: 2240–2247.
20. Kraitman RJ, Stetler-Stevenson M, Margulies I, et al. Phase II trial of recombinant immunotoxin RFB4(dsFv)-PE38 (BL22) in patients with hairy cell leukemia. J Clin Oncol 2009;27:2983–2990.
21. Matutes E, Meeus P, McLennan K, Catovsky D. The significance of minimal residual disease in hairy cell leukemia treated with deoxycoformycin:a long-term follow-up study. Br J Haematol 1997;98:375–383.
22. Konwalinka G, Schirmer M, Hilbe W, et al. Minimal residual disease in hairy-cell leukemia after treatment with 2-chlor- odeoxyadenosine. Blood Cells Mol Dis 1995;21:142–151.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122