Alternative Therapeutic Strategies in Purine Nucleoside Analogue Refractory Hairy Cell Leukemia

Chlorambucil,105 androgens,106 and lithium107 are rarely used today and are now principally of historic interest only.

Kreitman et al. have reported on a novel recombinant immunotoxin administered to patients with refractory HCL.108 This toxin targets CD25-expressing lymphoid malignancies through the Fc portion of anti-CD25 fused to the truncated portion of the Pseudomonas exotoxin. Of four patients, one achieved a complete response and three had at least 98 percent clearing of circulating hairy cells. Thomas et al. have reported on the administration of rituximab, the anti-CD20 monoclonal antibody (Rituxan; IDEC Pharmaceuticals, San Diego, CA) to refractory HCL patients.109 Four of five patients achieved responses, two being complete responses. Toxicity was mild and limited to rigors.

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