Hematologic improvement after flavopiridol treatment of pentostatin and rituximab refractory hairy cell leukemia

摘要

Initial therapy of hairy cell leukemia (HCL) with the purine analog pentostatin or cladribine achieves durable complete remission in 85-90% of patients. Most patients will achieve second remission when retreated with either drug, but complete remission is far less likely with subsequent courses [1]. Rituximab has activity in this setting, but response rates range from no more than 10 to 54%, emphasizing the need for novel therapies [2,3]. Promising responses after treatment with recombinant immunotoxins such as BL22 have recently been reported, but there are few other agents under active clinical investigation for this rare disease [4]. We report the case of a patient with longstanding HCL refractory to both pentostatin and rituximab who was successfully treated with the cyclin-dependent kinase inhibitor (CDKI) flavopiridol.