Division of Hematology/Oncology, Scripps Clinic Medical Group, 10666 N. Torrey Pines Rd, MS217, La Jolla, CA 92037, USA.
Blood. 2010 Mar 11;115(10):1893-6. doi: 10.1182/blood-2009-10-251645. Epub 2010 Jan 7.
Cladribine induces protracted remissions in patients with hairy cell leukemia (HCL). However, many long-term responders ultimately relapse. We sought to determine whether long-term complete responders subsequent to a single 7-day course of cladribine were without minimal residual disease (MRD) and potentially cured of HCL. From the 358-person Scripps Clinic cladribine database, we identified 19 patients in continuous and complete hematologic response (median age, 75 years; median time from diagnosis, 18 years; and median time from cladribine, 16 years). Nine of 19 (47%) patient samples had no evidence of residual disease; 7 of 19 (37%) samples had MRD; and 3 of 19 (16%) had morphologic evidence of HCL in hematoxylin and eosin-stained bone marrow sections. These results indicate that HCL is potentially curable after cladribine treatment. In addition, patients with MRD and even gross morphologic disease can live many years without manifesting hematologic relapses.
克拉屈滨可诱导慢性淋巴细胞白血病（HCL）患者获得长期缓解。然而，许多长期缓解者最终会复发。我们试图确定在接受单次 7 天克拉屈滨治疗后长期完全缓解的患者是否没有微小残留病（MRD），并且有可能治愈 HCL。从斯克里普斯诊所的 358 名克拉屈滨数据库中，我们确定了 19 名持续和完全血液学缓解的患者（中位年龄 75 岁；中位诊断后时间为 18 年；中位克拉屈滨后时间为 16 年）。19 名患者中有 9 名（47%）患者样本没有残留疾病的证据；19 名患者中有 7 名（37%）样本有 MRD；19 名患者中有 3 名（16%）在苏木精和伊红染色骨髓切片中存在 HCL 的形态学证据。这些结果表明，克拉屈滨治疗后 HCL 可能治愈。此外，即使有 MRD 甚至明显形态学疾病的患者也可以在没有明显血液学复发的情况下存活多年。
