Author/Editor		Mlakar, Uroš
Title		Zdravljenje bolnikov z dlakasto celično levkemijo s kladribinom
Translated title		Treatment of hairy cell leukemia with cladribine
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 67, št. Suppl 1
Publication year		1998
Volume		str. I-27-9
Language		slo
Abstract		Background. Since the introduction of interferon and newer purine analogues (pentostatin and cladribine) in the treatment of hairy cell leukaemia outcome of disease changed dramatically. Cladribine is emerging as the treatment of choice because of its favourable toxicity profile, brief duration of treatment and high percentage of long-lasting complete remissions. Methods and results. Filfteen patients with hairy cell leukaemia were treated with cladribine (0.1 mg/kg/day) for seven days. Seven patients had received prior interferon therapy. Complete haematological remission was achieved in nine (60%) patients and partial remission in six (40%). The follow up period varied between 6 and 31 months. One patient died six months after cladribine treatment because of pulmonary carcinoma. Other fourteen patients are still in remission. There were no serious side effects of treatment. Eight patients had short fever during or shortly after the treatment. Seven of these had fever in the setting of neutropenia. One patient required blood product supper after treatment. Conclusions. Treatment of hairy cell leukaemia with cladribine is highly effective with minor side effects. The selected group of patients with higher risk of serious infection or myelosupression may benefit of a different schedule of treatment.
Summary		Izhodišča. Z uporabo interferona alfa in novejših analogov purina (pentostatin, kladribin) za zdravljenje dlakasto celične levkemije se je prognoza bolezni znatno izboljšala. Kladribin se je najbolj uveljavil zaradi majhne toksičnosti, kratkotrajnega zdravljenja in visokega deleža dolgotrajnih remisij. metode in rezultati. Petnajst bolnikov z dlakasto celično levkemijo smo zdravili s kladribinom (0,1 mg/kg/dan sedem dni). Zdravljenje je trajalo sedem dni. Sedem bolnikov smo poprej zdravili z interferonom alfa. Popolno remisijo bolezni smo dosegli pri 9/15 (60%) bolnikov in delni odgovor pri 6/15 (40%). Bolnike smo po zdravljenju spremljali 6 do 31 mesecev. En bolnik je umrl šest mesecev po zdravljenju zaradi karcinoma pljuč. Remisija bolezni pri drugih bolnikih še vedno traja. Hujših neželenih učinkov zdravljenja nismo opazili. Osem bolnikov je zbolelo med zdravljenjem ali kmalu po njem z zvečano telesno temperaturo. Pri vseh, razen pri enem, je zvečana temperatura nastopila v obdobju nevtropenije. En bolnik je zaradi poslabšanja anemije potreboval transfuzijo eritrocitov kmalu po zaključku zdravljenja. Zaključki. Zdravljenje dlakastocelične levkemije s kladribinom je zelo učinkovito. Hujši neželeni učinki zdravljenja so redki. Pri bolnikih s povečanim tveganjem za resno okužbo lahko zmanjšamo to tveganje s spremembo načina zdravljenja.
Descriptors		LEUKEMIA, HAIRY CELL CLADRIBINE TREATMENT OUTCOME