Ravandi Farhad
Department of Leukemia, The University of Texas, MD Anderson Cancer Center, USA.
Best Pract Res Clin Haematol. 2015 Dec;28(4):230-5. doi: 10.1016/j.beha.2015.09.005. Epub 2015 Oct 8.
Success in the treatment of patients with hairy cell leukemia (HCL) over the last several decades is largely due to the high efficacy of the nucleoside analogs, cladribine and pentostatin. However, the relapse-free survival curves have not shown a plateau and many patients treated with these agents will eventually relapse. Although better understanding of the pathogenic mechanisms in HCL have led to effective and novel options for the treatment of relapse, long term durability of the responses obtained with these agents still remains unclear. Combination of nucleoside analogs with monoclonal antibodies such as rituximab has been shown to be safe and effective and has the potential to supersede the nucleoside analogs as the frontline strategy. Such chemo-immunotherapy approaches are under further investigation and will have to be assessed with socioeconomic considerations in mind. Other novel monoclonal antibodies, approved for the treatment of other lymphoid neoplasms, may also be considered for future studies of chemo-immunotherapy.
在过去几十年里，毛细胞白血病（HCL）患者治疗取得成功很大程度上归功于核苷类似物2-氯脱氧腺苷和喷司他丁的高效性。然而，无复发生存曲线并未出现平台期，许多接受这些药物治疗的患者最终会复发。尽管对HCL致病机制的更好理解带来了治疗复发的有效且新颖的选择，但这些药物所获反应的长期持久性仍不明确。核苷类似物与利妥昔单抗等单克隆抗体联合使用已被证明是安全有效的，并且有可能取代核苷类似物成为一线治疗策略。这种化学免疫疗法正在进一步研究中，并且必须在考虑社会经济因素的情况下进行评估。其他已被批准用于治疗其他淋巴系统肿瘤的新型单克隆抗体，也可考虑用于未来的化学免疫疗法研究。
