Background:
Deoxycoformycin (dcf) has been reported to produce high response rates in patients with hairy cell leukemia (hcl), but to the authors' knowledge data regarding experience with such therapy in a large hcl series are scarce.
Methods:
Between 1988-1997, dcf (4 mg/m(2)/day, every 2 weeks) was administered to 80 hcl patients in 32 spanish institutions. in 35 of 78 evaluable patients dcf was the first-line therapy; the remaining 43 patients had received other therapies. pretreatment variables influencing the achievement of complete remission (cr) and event free survival were identified by multivariate analyses.
Results:
The median number of cycles administered was 7 (range, 1-22 cycles). a cr was obtained in 56 patients (72%) and a partial remission was obtained in 13 patients, for an overall response rate of 88%. in the multivariate analysis previous splenectomy and an eastern cooperative oncology group (ecog) performance status > or = 2 were the parameters adversely influencing cr achievement. with a median follow-up of 31.2 months (range, 0.4-126.5 months), disease recurrence was observed in 11 of the cr patients, 5 of whom showed a further response to dcf. an ecog performance status > or = 2 was the only pretreatment variable associated with a shorter event free survival. seven patients died, four during the treatment period. the actuarial median event free survival was 46 months (95% confidence interval, 22.5-69.5 months), and 48.7% of the 56 patients who achieved a cr were expected to be alive and disease free at 5 years. hematologic toxicity (marked neutropenia [22 cases], anemia [6 cases], and thrombocytopenia [1 case]) was the main side effect, followed by nausea and emesis (5 cases); 14 patients required hospitalization.
Conclusions:
The results of the current study confirm the effectiveness and acceptable toxicity of dcf in the treatment of patients with hcl.