Saven A, Piro L D
Division of Hematology and Oncology, Ida M. and Cecil H. Green Cancer Center, Scripps Clinic and Research Foundation, La Jolla, California 92037.
Leuk Lymphoma. 1993;11 Suppl 2:109-14. doi: 10.3109/10428199309064270.
More than 450 patients with hairy cell leukemia have been treated at the Scripps Clinic. Of 144 patients followed for a median of 14.2 months (range, 8.1-70 months), 123 (85%) obtained complete responses, 17 (12%) partial responses, 3 (2%) did not respond, and 1 patient was unevaluable. So far, 4 patients have relapsed at a median of 36 months (range, 12-48 months). Fever was the principal toxicity occurring in 43% of patients. Five patients resistant (3 patients) or intolerant (2 patients) to deoxycoformycin were also treated. Of these 5 patients, 4 obtained complete responses, including 2 patients resistant to deoxycoformycin, and 1 patient a partial response, suggesting a possible lack of cross-resistance between deoxycoformycin and 2-CdA in hairy cell leukemia. Other single-institution studies have documented similar response rates and toxicities. Ninety patients with advanced chronic lymphocytic leukemia were treated with 2-CdA administered either as a 0.1 mg/kg/day 7-day continuous intravenous infusion or as a 0.028-0.14 mg/kg/day 2-hour bolus for 5 consecutive days. Four patients (4%) obtained complete responses and 36 patients (40%) partial responses, using NCI-sponsored Working Group guidelines. Of the 50 patients who were non-responders, 27 (54%) had a > or = 50% sustained reduction in the absolute lymphocyte count. The ratio of deoxycytidine kinase to cytoplasmic 5'-nucleotidase was predictive of 2-CdA responsiveness. Fourteen patients with fludarabine-failed chronic lymphocytic leukemia were also treated. No responses were achieved and 2 patients had progressive disease. Six patients had a > or = 50% reduction in the absolute lymphocyte count.(ABSTRACT TRUNCATED AT 250 WORDS)
超过450例毛细胞白血病患者在斯克里普斯诊所接受了治疗。在144例中位随访时间为14.2个月（范围8.1 - 70个月）的患者中，123例（85%）获得完全缓解，17例（12%）部分缓解，3例（2%）无反应，1例患者无法评估。到目前为止，4例患者复发，中位复发时间为36个月（范围12 - 48个月）。发热是43%的患者出现的主要毒性反应。还对5例对脱氧助间型霉素耐药（3例）或不耐受（2例）的患者进行了治疗。在这5例患者中，4例获得完全缓解，其中包括2例对脱氧助间型霉素耐药的患者，1例患者部分缓解，这表明在毛细胞白血病中脱氧助间型霉素和2 - 氯脱氧腺苷之间可能不存在交叉耐药。其他单机构研究也记录了类似的缓解率和毒性反应。90例晚期慢性淋巴细胞白血病患者接受了2 - 氯脱氧腺苷治疗，给药方式为0.1 mg/kg/天连续7天静脉输注或0.028 - 0.14 mg/kg/天2小时推注，连续5天。根据美国国立癌症研究所资助的工作组指南，4例患者（4%）获得完全缓解，36例患者（40%）部分缓解。在50例无反应的患者中，27例（54%）的绝对淋巴细胞计数持续下降≥50%。脱氧胞苷激酶与胞质5'-核苷酸酶的比值可预测2 - 氯脱氧腺苷的反应性。还对14例氟达拉滨治疗失败的慢性淋巴细胞白血病患者进行了治疗。未取得缓解，2例患者病情进展。6例患者的绝对淋巴细胞计数下降≥50%。（摘要截选至250字）
