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Rituximab as treatment for minimal residual disease in hairy cell leukaemia.

Abstract
Purine analogues have dramatically improved the outcome of patients affected by hairy cell leukemia (HCL), although complete eradication of disease was achieved in few cases. The purpose of this study was to evaluate the role of Rituximab in eradicating minimal residual disease (MRD) in HCL patients after a pre-treatment with 2-chloro-deoxy-adenosine (2-CdA). Ten patients received four cycles of Rituximab after administration of Cladribrine. Before starting anti-CD20 antibody, two patients were in complete remission, six in partial remission and two showed no significant response to Cladribrine. All cases resulted IgH-positive. Median time from the last 2-CdA infusion was 5.7 months. Eight of 10 patients [four in partial remission (PR), two in complete remission (CR) and two unresponsive after 2-CdA] were evaluable for response. Two months after the end of anti-CD20 therapy, all evaluated patients presented a complete haematological remission. Moreover, Rituximab increased percentage of molecular remission up to 100% 1 yr after the end of treatment. Interestingly, in all cases but one, including those persistently polymerase chain reaction (PCR)-positive, semi-quantitative molecular analyses showed MRD levels lower than those found before Rituximab administration. Toxicity was very mild. The present results not only confirm the therapeutic effect of Rituximab, but also show its relevance in eradicating MRD in HCL.
AuthorsGiulia Cervetti, Sara Galimberti, Francesca Andreazzoli, Rita Fazzi, Nadia Cecconi, Francesco Caracciolo, Mario Petrini
JournalEuropean journal of haematology (Eur J Haematol) Vol. 73 Issue 6 Pg. 412-7 (Dec 2004) ISSN: 0902-4441 [Print] England
PMID15522063 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antimetabolites, Antineoplastic
  • Cladribine
  • Rituximab
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal (adverse effects, therapeutic use)
  • Antibodies, Monoclonal, Murine-Derived
  • Antimetabolites, Antineoplastic (therapeutic use)
  • Cladribine (therapeutic use)
  • Combined Modality Therapy
  • Female
  • Humans
  • Hypotension (chemically induced)
  • Immunization, Passive
  • Leukemia, Hairy Cell (drug therapy, pathology, therapy)
  • Male
  • Middle Aged
  • Neoplasm, Residual
  • Remission Induction
  • Rituximab
  • Treatment Outcome

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