喷司他丁作为单药治疗HCL的疗效:在9项前瞻性试验进行了研究 [35]Flinn IW, Kopecky KJ, Foucar MK, et al. Long-term follow-up of remission duration, mortality, and second malignancies in hairy cell leukemia patients treated with pentostatin. Blood. 2000 Nov 1;96(9):2981-6.http://bloodjournal.hematologylibrary.org/cgi/content/full/96/9/2981http://www.ncbi.nlm.nih.gov/pubmed/11049974?tool=bestpractice.com[36]Dearden CE, Matutes E, Hilditch BL, et al. Long-term follow-up of patients with hairy cell leukaemia after treatment with pentostatin or cladribine. Br J Haematol. 1999 Aug;106(2):515-9.http://www.ncbi.nlm.nih.gov/pubmed/10460614?tool=bestpractice.com[37]Ho AD, Thaler J, Mandelli F, et al. Response to pentostatin in hairy-cell leukemia refractory to interferon-alpha. J Clin Oncol. 1989 Oct;7(10):1533-8.http://www.ncbi.nlm.nih.gov/pubmed/2789273?tool=bestpractice.com[38]Cassileth PA, Cheuvart B, Spiers AS, et al. Pentostatin induces durable remissions in hairy cell leukemia. J Clin Oncol. 1991 Feb;9(2):243-6.http://www.ncbi.nlm.nih.gov/pubmed/1988572?tool=bestpractice.com[39]Catovsky D, Matutes E, Talavera JG, et al. Long term results with 2'deoxycoformycin in hairy cell leukemia. Leuk Lymphoma. 1994;14(suppl 1):109-13.http://www.ncbi.nlm.nih.gov/pubmed/7820041?tool=bestpractice.com[40]Johnston JB, Eisenhauer E, Corbett WE, et al. Efficacy of 2'-deoxycoformycin in hairy-cell leukemia: a study of the National Cancer Institute of Canada Clinical Trials Group. J Natl Cancer Inst. 1988 Jul 20;80(10):765-9.http://www.ncbi.nlm.nih.gov/pubmed/3290498?tool=bestpractice.com[41]Kraut EH, Grever MR, Bouroncle BA. Long-term follow-up of patients with hairy cell leukemia after treatment with 2'-deoxycoformycin. Blood. 1994 Dec 15;84(12):4061-3.http://bloodjournal.hematologylibrary.org/cgi/reprint/84/12/4061http://www.ncbi.nlm.nih.gov/pubmed/7994024?tool=bestpractice.com[42]Maloisel F, Benboubker L, Gardembas M, et al. Long-term outcome with pentostatin treatment in hairy cell leukemia patients: a French retrospective study of 238 patients. Leukemia. 2003 Jan;17(1):45-51.http://www.ncbi.nlm.nih.gov/pubmed/12529659?tool=bestpractice.com[43]Rafel M, Cervantes F, Beltran JM, et al. Deoxycoformycin in the treatment of patients with hairy cell leukemia: results of a Spanish collaborative study of 80 patients. Cancer. 2000 Jan 15;88(2):352-7.http://www3.interscience.wiley.com/cgi-bin/fulltext/75504431/HTMLSTARThttp://www.ncbi.nlm.nih.gov/pubmed/10640967?tool=bestpractice.com[44]Ribeiro P, Bouaffia F, Peaud PY, et al. Long term outcome of patients with hairy cell leukemia treated with pentostatin. Cancer. 1999 Jan 1;85(1):65-71.http://www3.interscience.wiley.com/cgi-bin/fulltext/75503576/HTMLSTARThttp://www.ncbi.nlm.nih.gov/pubmed/9921975?tool=bestpractice.com 在2项随机对照试验中与干扰素α进行了比较。[35]Flinn IW, Kopecky KJ, Foucar MK, et al. Long-term follow-up of remission duration, mortality, and second malignancies in hairy cell leukemia patients treated with pentostatin. Blood. 2000 Nov 1;96(9):2981-6.http://bloodjournal.hematologylibrary.org/cgi/content/full/96/9/2981http://www.ncbi.nlm.nih.gov/pubmed/11049974?tool=bestpractice.com[45]Grever M, Kopecky K, Foucar MK, et al. Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia: an intergroup study. J Clin Oncol. 1995 Apr;13(4):974-82.http://www.ncbi.nlm.nih.gov/pubmed/7707126?tool=bestpractice.com 高质量证据证实喷司他丁的疗效,完全缓解率可以达到33.3%~100.0%,[35]Flinn IW, Kopecky KJ, Foucar MK, et al. Long-term follow-up of remission duration, mortality, and second malignancies in hairy cell leukemia patients treated with pentostatin. Blood. 2000 Nov 1;96(9):2981-6.http://bloodjournal.hematologylibrary.org/cgi/content/full/96/9/2981http://www.ncbi.nlm.nih.gov/pubmed/11049974?tool=bestpractice.com[37]Ho AD, Thaler J, Mandelli F, et al. Response to pentostatin in hairy-cell leukemia refractory to interferon-alpha. J Clin Oncol. 1989 Oct;7(10):1533-8.http://www.ncbi.nlm.nih.gov/pubmed/2789273?tool=bestpractice.com 并且改善总体生存(10年生存率80%)。[35]Flinn IW, Kopecky KJ, Foucar MK, et al. Long-term follow-up of remission duration, mortality, and second malignancies in hairy cell leukemia patients treated with pentostatin. Blood. 2000 Nov 1;96(9):2981-6.http://bloodjournal.hematologylibrary.org/cgi/content/full/96/9/2981http://www.ncbi.nlm.nih.gov/pubmed/11049974?tool=bestpractice.com 需要对喷司他丁和克拉屈滨进行头对头的比较性研究。
证据 B 克拉屈滨治疗HCL的疗效:来自12项前瞻性的单臂试验,完全缓解率在75%~95%的范围内。[46]Goodman GR, Burian C, Koziol JA, et al. Extended follow-up of patients with hairy cell leukemia after treatment with cladribine. J Clin Oncol. 2003 Mar 1;21(5):891-6.http://www.ncbi.nlm.nih.gov/pubmed/12610190?tool=bestpractice.com[47]Juliusson G, Liliemark J. Rapid recovery from cytopenia in hairy cell leukemia after treatment with 2-chloro-2'-deoxyadenosine (CdA): relation to opportunistic infections. Blood. 1992 Feb 15;79(4):888-94.http://bloodjournal.hematologylibrary.org/cgi/reprint/79/4/888http://www.ncbi.nlm.nih.gov/pubmed/1346578?tool=bestpractice.com[48]Chacko J, Murphy C, Duggan C, et al. Weekly intermittent 2-CdA is less toxic and equally efficacious when compared to continuous infusion in hairy cell leukaemia. Br J Haematol. 1999 Jun;105(4):1145-6.http://www.ncbi.nlm.nih.gov/pubmed/10554836?tool=bestpractice.com[36]Dearden CE, Matutes E, Hilditch BL, et al. Long-term follow-up of patients with hairy cell leukaemia after treatment with pentostatin or cladribine. Br J Haematol. 1999 Aug;106(2):515-9.http://www.ncbi.nlm.nih.gov/pubmed/10460614?tool=bestpractice.com[49]Estey EH, Kurzrock R, Kantarjian HM, et al. Treatment of hairy cell leukemia with 2-chlorodeoxyadenosine (2-CdA). Blood. 1992 Feb 15;79(4):882-7.http://bloodjournal.hematologylibrary.org/cgi/reprint/79/4/882http://www.ncbi.nlm.nih.gov/pubmed/1346577?tool=bestpractice.com[50]Hoffman MA, Janson D, Rose E, et al. Treatment of hairy-cell leukemia with cladribine: response, toxicity, and long-term follow-up. J Clin Oncol. 1997 Mar;15(3):1138-42.http://www.ncbi.nlm.nih.gov/pubmed/9060556?tool=bestpractice.com[51]Jehn U, Bartl R, Dietzfelbinger H, et al. Long-term outcome of hairy cell leukemia treated with 2-chlorodeoxyadenosine. Ann Hematol. 1999 Mar;78(3):139-44.http://www.ncbi.nlm.nih.gov/pubmed/10211756?tool=bestpractice.com[52]Juliusson G, Heldal D, Hippe E, et al. Subcutaneous injections of 2-chlorodeoxyadenosine for symptomatic hairy cell leukemia. J Clin Oncol. 1995 Apr;13(4):989-95.http://www.ncbi.nlm.nih.gov/pubmed/7707128?tool=bestpractice.com[53]Piro LD, Carrera CJ, Carson DA, et al. Lasting remissions in hairy-cell leukemia induced by a single infusion of 2-chlorodeoxyadenosine. N Engl J Med. 1990 Apr 19;322(16):1117-21.http://www.ncbi.nlm.nih.gov/pubmed/1969613?tool=bestpractice.com[54]Piro LD, Ellison DJ, Saven A. The Scripps Clinic experience with 2-chlorodeoxyadenosine in the treatment of hairy cell leukemia. Leuk Lymphoma. 1994;14(suppl 1):121-5.http://www.ncbi.nlm.nih.gov/pubmed/7820043?tool=bestpractice.com[55]Robak T, Blasinska-Morawiec M, Krykowski E, et al. 2-chlorodeoxyadenosine (2-CdA) in 2-hour versus 24-hour intravenous infusion in the treatment of patients with hairy cell leukemia. Leuk Lymphoma. 1996 Jun;22(1-2):107-11.http://www.ncbi.nlm.nih.gov/pubmed/8724536?tool=bestpractice.com[56]Saven A, Burian C, Koziol JA, et al. Long-term follow-up of patients with hairy cell leukemia after cladribine treatment. Blood. 1998 Sep 15;92(6):1918-26.http://bloodjournal.hematologylibrary.org/cgi/content/full/92/6/1918http://www.ncbi.nlm.nih.gov/pubmed/9731048?tool=bestpractice.com[57]Seymour JF, Kurzrock R, Freireich EJ, et al. 2-chlorodeoxyadenosine induces durable remissions and prolonged suppression of CD4+ lymphocyte counts in patients with hairy cell leukemia. Blood. 1994 May 15;83(10):2906-11.http://bloodjournal.hematologylibrary.org/cgi/reprint/83/10/2906http://www.ncbi.nlm.nih.gov/pubmed/7910051?tool=bestpractice.com[58]Tallman MS, Hakimian D, Rademaker AW, et al. Relapse of hairy cell leukemia after 2-chlorodeoxyadenosine: long-term follow-up of the Northwestern University experience. Blood. 1996 Sep 15;88(6):1954-9.http://bloodjournal.hematologylibrary.org/cgi/reprint/88/6/1954http://www.ncbi.nlm.nih.gov/pubmed/8822913?tool=bestpractice.com[59]Tallman MS, Hakimian D, Variakojis D, et al. A single cycle of 2-chlorodeoxyadenosine results in complete remission in the majority of patients with hairy cell leukemia. Blood. 1992 Nov 1;80(9):2203-9.http://bloodjournal.hematologylibrary.org/cgi/reprint/80/9/2203http://www.ncbi.nlm.nih.gov/pubmed/1358262?tool=bestpractice.com[60]von Rohr A, Schmitz SF, Tichelli A, et al. Treatment of hairy cell leukemia with cladribine (2-chlorodeoxyadenosine) by subcutaneous bolus injection: a Phase II study. Ann Oncol. 2002 Oct;13(10):1641-9.http://annonc.oxfordjournals.org/cgi/content/full/13/10/1641http://www.ncbi.nlm.nih.gov/pubmed/12377655?tool=bestpractice.com 克拉屈滨的疗效尚未在随机对照试验中评估。需要克拉屈滨和喷司他丁的头对头的比较性研究。 系统评价或者受试者>200名的随机对照临床试验(RCT)。克拉屈滨治疗HCL的疗效:来自12项前瞻性的单臂试验,完全缓解率在75%~95%的范围内。[46]Goodman GR, Burian C, Koziol JA, et al. Extended follow-up of patients with hairy cell leukemia after treatment with cladribine. J Clin Oncol. 2003 Mar 1;21(5):891-6.http://www.ncbi.nlm.nih.gov/pubmed/12610190?tool=bestpractice.com[47]Juliusson G, Liliemark J. Rapid recovery from cytopenia in hairy cell leukemia after treatment with 2-chloro-2'-deoxyadenosine (CdA): relation to opportunistic infections. Blood. 1992 Feb 15;79(4):888-94.http://bloodjournal.hematologylibrary.org/cgi/reprint/79/4/888http://www.ncbi.nlm.nih.gov/pubmed/1346578?tool=bestpractice.com[48]Chacko J, Murphy C, Duggan C, et al. Weekly intermittent 2-CdA is less toxic and equally efficacious when compared to continuous infusion in hairy cell leukaemia. Br J Haematol. 1999 Jun;105(4):1145-6.http://www.ncbi.nlm.nih.gov/pubmed/10554836?tool=bestpractice.com[36]Dearden CE, Matutes E, Hilditch BL, et al. Long-term follow-up of patients with hairy cell leukaemia after treatment with pentostatin or cladribine. Br J Haematol. 1999 Aug;106(2):515-9.http://www.ncbi.nlm.nih.gov/pubmed/10460614?tool=bestpractice.com[49]Estey EH, Kurzrock R, Kantarjian HM, et al. Treatment of hairy cell leukemia with 2-chlorodeoxyadenosine (2-CdA). Blood. 1992 Feb 15;79(4):882-7.http://bloodjournal.hematologylibrary.org/cgi/reprint/79/4/882http://www.ncbi.nlm.nih.gov/pubmed/1346577?tool=bestpractice.com[50]Hoffman MA, Janson D, Rose E, et al. Treatment of hairy-cell leukemia with cladribine: response, toxicity, and long-term follow-up. J Clin Oncol. 1997 Mar;15(3):1138-42.http://www.ncbi.nlm.nih.gov/pubmed/9060556?tool=bestpractice.com[51]Jehn U, Bartl R, Dietzfelbinger H, et al. Long-term outcome of hairy cell leukemia treated with 2-chlorodeoxyadenosine. Ann Hematol. 1999 Mar;78(3):139-44.http://www.ncbi.nlm.nih.gov/pubmed/10211756?tool=bestpractice.com[52]Juliusson G, Heldal D, Hippe E, et al. Subcutaneous injections of 2-chlorodeoxyadenosine for symptomatic hairy cell leukemia. J Clin Oncol. 1995 Apr;13(4):989-95.http://www.ncbi.nlm.nih.gov/pubmed/7707128?tool=bestpractice.com[53]Piro LD, Carrera CJ, Carson DA, et al. Lasting remissions in hairy-cell leukemia induced by a single infusion of 2-chlorodeoxyadenosine. N Engl J Med. 1990 Apr 19;322(16):1117-21.http://www.ncbi.nlm.nih.gov/pubmed/1969613?tool=bestpractice.com[54]Piro LD, Ellison DJ, Saven A. The Scripps Clinic experience with 2-chlorodeoxyadenosine in the treatment of hairy cell leukemia. Leuk Lymphoma. 1994;14(suppl 1):121-5.http://www.ncbi.nlm.nih.gov/pubmed/7820043?tool=bestpractice.com[55]Robak T, Blasinska-Morawiec M, Krykowski E, et al. 2-chlorodeoxyadenosine (2-CdA) in 2-hour versus 24-hour intravenous infusion in the treatment of patients with hairy cell leukemia. Leuk Lymphoma. 1996 Jun;22(1-2):107-11.http://www.ncbi.nlm.nih.gov/pubmed/8724536?tool=bestpractice.com[56]Saven A, Burian C, Koziol JA, et al. Long-term follow-up of patients with hairy cell leukemia after cladribine treatment. Blood. 1998 Sep 15;92(6):1918-26.http://bloodjournal.hematologylibrary.org/cgi/content/full/92/6/1918http://www.ncbi.nlm.nih.gov/pubmed/9731048?tool=bestpractice.com[57]Seymour JF, Kurzrock R, Freireich EJ, et al. 2-chlorodeoxyadenosine induces durable remissions and prolonged suppression of CD4+ lymphocyte counts in patients with hairy cell leukemia. Blood. 1994 May 15;83(10):2906-11.http://bloodjournal.hematologylibrary.org/cgi/reprint/83/10/2906http://www.ncbi.nlm.nih.gov/pubmed/7910051?tool=bestpractice.com[58]Tallman MS, Hakimian D, Rademaker AW, et al. Relapse of hairy cell leukemia after 2-chlorodeoxyadenosine: long-term follow-up of the Northwestern University experience. Blood. 1996 Sep 15;88(6):1954-9.http://bloodjournal.hematologylibrary.org/cgi/reprint/88/6/1954http://www.ncbi.nlm.nih.gov/pubmed/8822913?tool=bestpractice.com[59]Tallman MS, Hakimian D, Variakojis D, et al. A single cycle of 2-chlorodeoxyadenosine results in complete remission in the majority of patients with hairy cell leukemia. Blood. 1992 Nov 1;80(9):2203-9.http://bloodjournal.hematologylibrary.org/cgi/reprint/80/9/2203http://www.ncbi.nlm.nih.gov/pubmed/1358262?tool=bestpractice.com[60]von Rohr A, Schmitz SF, Tichelli A, et al. Treatment of hairy cell leukemia with cladribine (2-chlorodeoxyadenosine) by subcutaneous bolus injection: a Phase II study. Ann Oncol. 2002 Oct;13(10):1641-9.http://annonc.oxfordjournals.org/cgi/content/full/13/10/1641http://www.ncbi.nlm.nih.gov/pubmed/12377655?tool=bestpractice.com 克拉屈滨的疗效尚未在随机对照试验中评估。需要克拉屈滨和喷司他丁的头对头的比较性研究。
证据 C 利妥昔单抗在复发或难治HCL患者中的疗效:5项前瞻性试验,总体反应率在25%~80%之间。[68]Hagberg H, Lundholm L. Rituximab, a chimaeric anti-CD20 monoclonal antibody, in the treatment of hairy cell leukaemia. Br J Haematol. 2001 Dec;115(3):609-11.http://www.ncbi.nlm.nih.gov/pubmed/11736943?tool=bestpractice.com[69]Lauria F, Lenoci M, Annino L, et al. Efficacy of anti-CD20 monoclonal antibodies (Mabthera) in patients with progressed hairy cell leukemia. Haematologica. 2001 Oct;86(10):1046-50.http://www.haematologica.org/cgi/reprint/86/10/1046http://www.ncbi.nlm.nih.gov/pubmed/11602410?tool=bestpractice.com[70]Nieva J, Bethel K, Saven A. Phase 2 study of rituximab in the treatment of cladribine-failed patients with hairy cell leukemia. Blood. 2003 Aug 1;102(3):810-3.http://bloodjournal.hematologylibrary.org/cgi/content/full/102/3/810http://www.ncbi.nlm.nih.gov/pubmed/12663446?tool=bestpractice.com[71]Thomas DA, O'Brien S, Bueso-Ramos C, et al. Rituximab in relapsed or refractory hairy cell leukemia. Blood. 2003 Dec 1;102(12):3906-11.http://bloodjournal.hematologylibrary.org/cgi/content/full/102/12/3906http://www.ncbi.nlm.nih.gov/pubmed/12816862?tool=bestpractice.com[72]Zenhausern R, Simcock M, Gratwohl A, et al. Rituximab in patients with hairy cell leukemia relapsing after treatment with 2-chlorodeoxyadenosine (SAKK 31/98). Haematologica. 2008 Sep;93(9):1426-8.http://www.haematologica.org/cgi/content/full/93/9/1426http://www.ncbi.nlm.nih.gov/pubmed/18603561?tool=bestpractice.com 需进行随机对照试验评估利妥昔单抗的疗效。 系统评价或者受试者>200名的随机对照临床试验(RCT)。利妥昔单抗在复发或难治HCL患者中的疗效:5项前瞻性试验,总体反应率在25%~80%之间。[68]Hagberg H, Lundholm L. Rituximab, a chimaeric anti-CD20 monoclonal antibody, in the treatment of hairy cell leukaemia. Br J Haematol. 2001 Dec;115(3):609-11.http://www.ncbi.nlm.nih.gov/pubmed/11736943?tool=bestpractice.com[69]Lauria F, Lenoci M, Annino L, et al. Efficacy of anti-CD20 monoclonal antibodies (Mabthera) in patients with progressed hairy cell leukemia. Haematologica. 2001 Oct;86(10):1046-50.http://www.haematologica.org/cgi/reprint/86/10/1046http://www.ncbi.nlm.nih.gov/pubmed/11602410?tool=bestpractice.com[70]Nieva J, Bethel K, Saven A. Phase 2 study of rituximab in the treatment of cladribine-failed patients with hairy cell leukemia. Blood. 2003 Aug 1;102(3):810-3.http://bloodjournal.hematologylibrary.org/cgi/content/full/102/3/810http://www.ncbi.nlm.nih.gov/pubmed/12663446?tool=bestpractice.com[71]Thomas DA, O'Brien S, Bueso-Ramos C, et al. Rituximab in relapsed or refractory hairy cell leukemia. Blood. 2003 Dec 1;102(12):3906-11.http://bloodjournal.hematologylibrary.org/cgi/content/full/102/12/3906http://www.ncbi.nlm.nih.gov/pubmed/12816862?tool=bestpractice.com[72]Zenhausern R, Simcock M, Gratwohl A, et al. Rituximab in patients with hairy cell leukemia relapsing after treatment with 2-chlorodeoxyadenosine (SAKK 31/98). Haematologica. 2008 Sep;93(9):1426-8.http://www.haematologica.org/cgi/content/full/93/9/1426http://www.ncbi.nlm.nih.gov/pubmed/18603561?tool=bestpractice.com 需进行随机对照试验评估利妥昔单抗的疗效。
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