Acute Myeloid Leukemia Following Treatment with Cladribine for Hairy Cell Leukemia: A Case Report and Review of the Literature

Hassan, Rosline; Gupta, Mohit; Kern, William; Ozer, Howard

doi:10.1080/10428190410001714070

Cited by 16 publications

(9 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The consequences resulting from myelosuppression include inter alia, leukopenia, thrombocytopenia, and anemia. The side effects of cladribine also include bacterial, viral, and fungal infections; disorders of the nervous system (headaches, dizziness, insomnia, anxiety, peripheral neuropathy), cardiac insufficiency, nephropathy, disorders of the gastrointestinal tract (nausea, vomiting, abdominal pain), musculoskeletal disorders, local skin reactions, teratogenicity and infertility, and also secondary malignancies, such as, acute myeloid leukemia (AML), non-Hodgkin lymphoma (NHL) (Chubar and Bennett 2003; Rossini et al 2004; Hassan et al 2004; Marczak et al 2004; Saven et al 1998; Tawfik and Nasr 2011). …”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical evaluation of cell proliferation and apoptosis markers in ovarian surface epithelial cells of cladribine-treated rats

et al. 2013

View full text Add to dashboard Cite

Cladribine has been used in the treatment of hairy cell leukemia for about 30 years. In addition, the number of indications for the application of 2-CdA is constantly increasing. The treatment with cladribine, of younger persons and even children, appears to be a major factor stimulating the more exact recognition of its activities. However, till now, little has been known about the impact of cladribine on the reproductive system. The aim of the study was to evaluate the immunohistochemical expression of cell proliferation and apoptosis markers in ovarian surface epithelial (OSE) cells. In our study, ten rats were placed into two equal groups. The study group received daily subcutaneous injections of cladribine in a dose of 0.10 mg/kg of weight/day for one cycle lasting 7 days. The control group received only saline injections. The rats were sacrificed 24 h after the last injection, and their ovaries were extracted. The sections were immunohistochemically stained with cell proliferation marker Ki-67 and the apoptosis marker caspase 3. The expressions of the markers were evaluated using a light microscope. An analysis was made using an image analysis system and the CellAD software. The results were then statistically explored by way of the Mann–Whitney U test. The proliferative index (Ki-67) of ovarian surface epithelial cells was significantly lower in the study group than in the control group (p < 0.05). These results suggest that cladribine treatment has a potential to inhibit the OSE cell proliferation in rats. The apoptosis marker demonstrated a significant increase after the cladribine treatment. These suggest that cladribine induces apoptosis in OSE cells.

show abstract

Section: Introductionmentioning

confidence: 99%

Immunohistochemical evaluation of cell proliferation and apoptosis markers in ovarian surface epithelial cells of cladribine-treated rats

et al. 2013

View full text Add to dashboard Cite

show abstract

“…By contrast, its use in other indolent lymphomas is relatively rare in spite of solid response rates [14,15]. This is probably not only because of high acute toxicity with grade III/IV neutropenia in more than 80% of treated HCL patients [12] but also because of reports on increased hematological long-term toxicities including prolonged pancytopenia and leukemia development, respectively [12,19,20,[22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…However, other studies using cladribine have reported the potential for severe acute hematological toxicity and prolonged pancytopenia [12,[19][20][21]. In addition, an increased risk of myelodysplastic syndromes (MDSs) and leukemia has been suggested, which might be a caveat for use in a mostly asymptomatic patient population with a median survival of more than 10 years [19,[22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Long‐term safety and activity of cladribine in patients with extranodal B‐cell marginal zone lymphoma of the mucosa‐associated lymphoid tissue (MALT) lymphoma

Kiesewetter

Dolak

Simonitsch‐Klupp

et al. 2015

Hematological Oncology

View full text Add to dashboard Cite

The purine analogue 2-chloro-deoxyadenosine (2-CDA, cladribine) +/- rituximab has been successfully tested in mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) patients. However, studies using cladribine in other indications have reported the potential for prolonged hematological side effects and secondary hematologic and non-hematologic malignancies. To date, there have been no data on long-term effects of cladribine in MALT lymphoma patients. We have analyzed a large number of 49 patients treated with cladribine at our institution 1997-2011. All patients were treated within clinical trials and had undergone a standardized follow-up protocol minimizing a potential bias in the detection of late sequels and relapses. After a median follow-up time of 61 months (interquartile range: 43-72) for 49 analyzed patients, 35 (71%) are alive, while 14 (29%) have died. In the entire collective, three cases (6%) of prolonged pancytopenia including manifest myelodysplastic syndrome in one patient (2%), three cases (6%) of secondary lymphoid malignancies, and five cases (10%) of non-hematologic cancers were documented. In terms of outcome, 42/49 (86%) patients responded to cladribine-containing treatment, and only 10/42 (24%) responding patients needed further treatment after a median time to progression of 14 months (interquartile range, 8-34). Currently, 25/35 (71%) patients being alive are in ongoing complete remission and 2/35 (6%) in ongoing stable disease, respectively. Eight patients (23%) are free of lymphoma after second-line therapy, with the median overall survival not having been reached. Our data suggest that cladribine might be safely applied in patients with MALT lymphoma, also in terms of long-term toxicities. These data also confirm the potential of cladribine to induce durable remissions. Copyright © 2015 John Wiley & Sons, Ltd.

show abstract

“…68 After the remarkable improvement of hematologic parameters with successful induction of a complete remission, the bone marrow serves as a well-documented locus for minimal residual disease. [72][73][74][75] Optimizing the treatment of hairy cell leukemia is needed because these patients, with a median age at diagnosis of 55 years, have a substantial rate of relapse. [69][70][71] The preliminary evidence suggests that cross-talk between the leukemic cells and the microenvironment provides a potential novel strategy for seeking effective therapy.…”

Section: Potential New Avenues For Therapeutic Research In Hairy Cellmentioning

confidence: 99%

Modern Strategies for Hairy Cell Leukemia

Grever

Lozanski

2011

JCO

View full text Add to dashboard Cite

Enormous progress in the treatment of hairy cell leukemia over the last five decades has emerged as a result of organized clinical investigations. Although interferon represented one of the initial major therapeutic advances in the management of this disease in 1984, the subsequent introduction of purine nucleoside analogs (pentostatin and cladribine) changed the natural history of this rare disease by achieving a high rate of complete and durable remissions. The disease-free survival after effective therapy has not reached a plateau, suggesting control but not cure of the disease. Identification of minimal residual disease in patients achieving a complete hematologic remission provides insight into the potential source for predicting eventual relapse. Modern strategies of targeted therapies directed against immunophenotypic markers on the leukemic cells provide hope that improved long-term control of the disease is possible. Combined chemoimmunotherapy may hold the highest promise for disease eradication, but the optimal strategy for using this approach is under active investigation. Despite the perception by hematologists that this disease has already been conquered, there are critically important unanswered questions that remain. Investigation of the bone marrow microenvironment and its impact on minimal residual disease may ultimately prevent relapse. Consideration of the median age of patients at diagnosis combined with a substantial relapse rate mandates continued pursuit of improved therapy. The ultimate goal will be to achieve cure rather than simple control of the disease.

show abstract

Acute Myeloid Leukemia Following Treatment with Cladribine for Hairy Cell Leukemia: A Case Report and Review of the Literature

Cited by 16 publications

References 3 publications

Immunohistochemical evaluation of cell proliferation and apoptosis markers in ovarian surface epithelial cells of cladribine-treated rats

Immunohistochemical evaluation of cell proliferation and apoptosis markers in ovarian surface epithelial cells of cladribine-treated rats

Long‐term safety and activity of cladribine in patients with extranodal B‐cell marginal zone lymphoma of the mucosa‐associated lymphoid tissue (MALT) lymphoma

Modern Strategies for Hairy Cell Leukemia

Contact Info

Product

Resources

About