Treatment results

Cassileth et al. reported on 50 patients with hairy cell leukemia treated with DCF and followed for a median of 39 months.24 After treatment for a median of 3 months, patients achieved a 64% CR and a 20% PR rate, with relapses in 6 of the 42 responders (14%) (see Table 31.2). In another early trial through the National Cancer Institute-Canadian Clinical Trials Group, Johnston et al. documented a CR in 25 of 28 (89%) evaluable patients with all remaining patients achieving a PR (11%).25 Patients were treated with 4 mg/m2 intravenously weekly for three consecutive weeks, repeated every 8 weeks, and continued for two additional cycles beyond CR. Overall toxicity included a 48% incidence of fever and infection, a 62% incidence of lethargy, and a 76% incidence of nausea and vomiting. Additional side effects included anorexia, dry skin, altered taste, and paresthesias.

Early results from the Eastern Cooperative Oncology Group, reported by Spiers et al., used a regimen of 5 mg/m2 given on two consecutive days every 2 weeks until a CR was attained.26 In 34 patients treated with this approach, 53% achieved a CR and 38% a PR. Treatment with DCF was associated with a 96% incidence of Grade 3/4 myelosuppression, a 19% incidence of serious infection, and two treatment related fatalities. With a median follow-up of 82 months, Kraut et al. described their experience in a group of 24 patients with HCL treated with DCF delivered every other week at a

Table 31.2

Trial results of DCF in

hairy cell leukem

ia

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