scholarly journals Current role of interferon in hairy cell leukemia therapy: a timely decision

2019 ◽  
Vol 41 (1) ◽  
pp. 88-90 ◽  
Author(s):  
Wellington Fernandes da Silva ◽  
Larissa Lane Cardoso Teixeira ◽  
Vanderson Rocha ◽  
Valeria Buccheri
1994 ◽  
Vol 12 (2) ◽  
pp. 268-272 ◽  
Author(s):  
D Hakimian ◽  
M S Tallman ◽  
D K Hogan ◽  
A W Rademaker ◽  
E Rose ◽  
...  

PURPOSE To determine the role of computed tomography (CT) in patients with hairy cell leukemia (HCL), we report a series of 43 patients prospectively evaluated for internal adenopathy by CT before and after treatment with 2-chlorodeoxyadenosine (2-CdA). PATIENTS AND METHODS CT was performed on 43 consecutive patients with HCL before and 3 months after a single cycle of 2-CdA. Twenty-four patients were previously diagnosed and 19 were newly diagnosed. Adenopathy was considered bulky if the greatest dimension of any confluent mass was between 5 and 10 cm and massive if greater than 10 cm. RESULTS Internal adenopathy was present in six of 43 patients (14%). Three of the six patients had massive abdominal adenopathy and one had bulky abdominal adenopathy. All six patients with adenopathy were previously diagnosed, while none of the 19 newly diagnosed patients had internal adenopathy. In those patients previously diagnosed, the six with adenopathy had a median disease duration of 68 months, while the 18 patients without adenopathy had a median disease duration of 24 months (P = .01). Adenopathy was more common in splenectomized patients. In previously diagnosed patients, adenopathy occurred in five of 10 (50%) splenectomized patients and one of 14 (7%) nonsplenectomized patients (P = .05). However, the 10 splenectomized patients had a median disease duration of 56 months, while the 14 nonsplenectomized patients had a median disease duration of 16 months (P = .004). All six patients had significant reduction in adenopathy 3 months after 2-CdA and were without residual HCL in the bone marrow. CONCLUSION Significant internal adenopathy in patients with HCL is more frequent than previously recognized. Adenopathy is rare at diagnosis and appears to be related to disease duration. As patients treated with 2-CdA have long disease-free survival durations, detection of significant adenopathy by CT scan may be important; however, routine CT scans are not recommended at the time of diagnosis.


Blood ◽  
2003 ◽  
Vol 102 (3) ◽  
pp. 1051-1056 ◽  
Author(s):  
Khalil A. Aziz ◽  
Kathleen J. Till ◽  
Haijuan Chen ◽  
Joseph R. Slupsky ◽  
Fiona Campbell ◽  
...  

Abstract Bone marrow (BM) fibrosis is a central diagnostic and pathogenetic feature of hairy-cell leukemia (HCL). It is known that fibronectin (FN) produced and assembled by the malignant hairy cells (HCs) themselves is a major component of this fibrosis. It is also known that FN production is greatly enhanced by adhesion of HCs to hyaluronan (HA) via CD44. The aim of the present study was to establish the roles of fibrogenic autocrine cytokines (fibroblast growth factor-2 [FGF-2] and transforming growth factor β [TGFβ]) and of different isoforms of CD44 in this FN production. We show that HC adhesion to HA stimulates FGF-2, but not TGFβ, production and that HCs possess FGF-2 receptor. In a range of experiments, FN production was greatly reduced by blocking FGF-2 but not TGFβ. Moreover FN, but not FGF-2, secretion was blocked by down-regulation of the v3 isoform of CD44 and by addition of heparitinase. These results show that autocrine FGF-2 secreted by HCs is the principal cytokine responsible for FN production by these cells when cultured on HA. The central role of FGF-2 in the pathogenesis of the BM fibrosis of HCL was supported by our immunohistochemical demonstration of large amounts of this cytokine in fibrotic BM but not in HCL spleen where there is no fibrosis. As regards CD44 isoforms, the present work demonstrates that CD44v3 is essential for providing the heparan sulfate necessary for HC stimulation by FGF-2, whereas the signal for production of the cytokine was provided by HA binding to CD44H, the standard hematopoietic form of the molecule.


Cancer ◽  
2007 ◽  
Vol 110 (10) ◽  
pp. 2240-2247 ◽  
Author(s):  
Monica Else ◽  
Nnenna Osuji ◽  
Francesco Forconi ◽  
Claire Dearden ◽  
Ilaria Del Giudice ◽  
...  

Author(s):  
Muhammad Sardar ◽  
JEMIN ABY JOSE ◽  
Mohammad Azfar Bilal ◽  
Chaudhry Saad Sohail ◽  
Heyyan Bin Khalil

2007 ◽  
Vol 170 (2) ◽  
pp. 745-754 ◽  
Author(s):  
Joseph R. Slupsky ◽  
Aura S. Kamiguti ◽  
Robert J. Harris ◽  
John C. Cawley ◽  
Mirko Zuzel

1988 ◽  
Vol 6 (11) ◽  
pp. 1714-1721 ◽  
Author(s):  
M J Ratain ◽  
H M Golomb ◽  
J W Vardiman ◽  
C A Westbrook ◽  
C Barker ◽  
...  

Sixty-nine patients with hairy-cell leukemia (HCL) were treated with interferon alfa-2b (IFN) in a single-institution study. The dose used was 2 x 10(6) U/m2 self-administered subcutaneously three times weekly, for a planned treatment duration of 12 to 18 months. Of the 68 evaluable patients, the major response rate was 75%, with 13% complete responses (CRs) and 62% partial responses (PRs). An additional eleven patients (16%) had minor responses (MRs). Duration of response was denoted as failure-free survival (FFS), defined as the time from the end of IFN therapy to a need for further antileukemic therapy. Of the 60 responding patients followed after discontinuation of IFN, 27 have relapsed, requiring further therapy. The median actuarial FFS for these 60 patients is 25.4 months. All but five patients are alive, and the actuarial overall survival for the 69 patients is 91% +/- 4% at 4 years from the start of IFN. The best indicators of relapse were the neutrophil alkaline phosphatase (NAP) score and degree of residual bone marrow hairy cells (%HCL) at the completion of therapy. Patients with NAP less than 30 (n = 21) had the best prognosis (median FFS, 30.4 months), while those with NAP greater than or equal to 30 and %HCL less than or equal to 30 (n = 21) or %HCL greater than 30 (n = 16) had intermediate and poor prognoses, respectively (median FFS, 23.5 and 12.4 months) (P = .0005). Fourteen of the relapsing patients are evaluable for response to a second course of IFN, with seven PRs and four MRs. Stratified randomized trials are indicated to determine the role of maintenance therapy for responding patients.


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