Long‐term follow‐up and second malignancies in 487 patients with hairy cell leukaemia

Abstract

SummaryA large, multicentre, retrospective survey of patients with hairy cell leukaemia (HCL) was conducted in France to determine the frequency of second malignancies and to analyse the long-term effects of the established purine nucleoside analogues (PNAs), cladribine and pentostatin. The survey retrospectively reviewed the medical history of patients and their immediate family, clinical and biological presentation at the time of HCL diagnosis, treatment choice, response to treatment, time to relapse and cause of death. Data were collected for 487 patients with HCL. Of the patients included in the survey, 18% (88/487) had a familial history of cancers, 8% (41/487) presented with malignancies before HCL diagnosis and 10% (48/487) developed second malignancies after HCL was diagnosed. An excess incidence of second malignancies was observed, with a standardized incidence ratio (SIR) of 1Á86 (95% confidence interval (CI): 1Á34-2Á51), with no significant difference between PNAs. For second haematological malignancies alone, the SIR was markedly increased at 5Á32 (95% CI: 2Á90-8Á92). This study highlights the high frequency of cancers in HCL patients and their family members. The frequency of second malignancies is notably increased, particularly for haematological malignancies. The respective role of pentostatin and cladribine in the development of second malignancies is debatable.

Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia

“…[14][15][16][17][18][19][20][21] Nevertheless, patients relapse and require additional therapy. Substantial variability has been introduced into how these agents are administered.…”

Are Cladribine and Rituximab Enough for the Treatment of Relapsed Hairy Cell Leukemia?

“…The monitoring of the evolution of our patient involves the early detection of possible infections, autoimmune diseases [23] or a new malignancy [24]. Patients with HCL, who have a dysfunctional immune response [23], are prone to develop one or more of these complications.…”

“…Patients with HCL, who have a dysfunctional immune response [23], are prone to develop one or more of these complications. In a survey made on 487 patients with HCL, 18% presented a familial history of cancers, 8% were diagnosed with malignancies before HCL diagnosis and 10% developed a second cancer after HCL was diagnosed [24]. The role of purine analogs in the appearance of a second malignancy is subject that deserves to be analyzed.…”

Hairy Cell Leukemia Presenting with Isolated Bone Lesions

“…Saçlı hücreli lösemi hastalarının çoğunda büyük boyutlara ulaşabilen splenomegali gözlenmektedir (2,3). Bizim hastamızda dalak boyutları normalin üst sınırında olup bu bulgular saçlı hücreli lösemi için tipik değildir.…”

“…Saçlı hücreli lösemi Dünya Sağlık Örgütü (DSÖ) 2008 kriterlerine göre B hücrelerden köken alan kronik lenfoproliferatif bir hastalıktır (1). Saçlı hücreli löse-mi hastalarında splenomegali ve pansitopeni sık rastlanan bulgulardır (2,3). Saçlı hücreli löseminin izole litik kemik lezyonu tutulumu şeklinde klinik bulgularla karakterli olguları çok nadir olup literatürde sadece olgu sunumları şeklinde bildirilmiştir (4).…”