Senem MARAL, Murat ALBAYRAK, Hacer Berna AFACAN ÖZTÜRK, Abdulkerim YILDIZ, Pınar CÖMERT, Buğra SAĞLAM, Mesut TIĞLIOĞLU, Merih Reis ARAS

Saçlı Hücreli Lösemi Tedavisinde Kladribinin Prognoza Etkisi

Saçlı hücreli lösemi (SHL) nadir görülen kronik lenfoproliferatif hastalıklar arasında yer alan, relaps ve remisyonlar ile seyreden indolent bir lenfomadır. Tedavisinde pürin analoğu (PA) kullanımı ile hastaların prognoz ve sağ kalımında önemli gelişmeler kaydedilmiştir. Bu çalışmamızda ilk basamakta kullanılan purin analogu tedavisinin iki farklı protokol ile verilmesinin nüks ve sağ kalım üzerine etkisini araştırdık. Kliniğimizde 2009-2019 yılları arasında SHL nedeniyle PA ile tedavi edilen 20 vakayı retrospektif olarak inceledik. Bunlardan tek siklus PA uygulanan hastalar ile iki siklüs ardışık PA tedavisi alan hasta gruplarını tanı anındaki klinik özellikleri, laboratuvar bulguları yanıt ve nüks oranları açısından karşılaştırdık. Her iki grupta yanıt oranları eşit olmakla birlikte, ilk basamak tedaviye tam yanıt oranı %90, kısmı yanıt oranı %10 olarak değerlendirilmiştir. Hastalarımızın median takip süresi 69 aydır ve bu süre içerisinde her iki gruptan birer hastada nüks izlenmiştir. Tek siklus tedavi alan hastalardan 1 tanesi hastalık dışı nedenle eks olmuştur. Ardışık iki siklus 2Cd-A uygulanmasının yanıt ve nüks oranı ilişkili üstünlüğü gösterilememiştir. İlk basamak tedavide uygulanan 2Cd-A, yüksek yanıt oranı ile etkili bir ajandır.

Anahtar Kelimeler:

Saçlı Hücreli Lösemi, Kladribin, Prognoz

Cladribine Treatment in Hairy Cell Leukemia

Hairy cell leukemia (HCL), which is a rare chronic lymphoproliferative disease, progresses with relapses and remissions. With the introduction of purine analogues (PA) in the treatment, significant improvements have been achieved in the prognosis and survival of patients. In this study, we investigated the effect of PA on relapse and survival in the first line treatment with two different protocols. We retrospectively analyzed 20 HCL patients who treated with PA between 2009-2019. We compared the patients who were treated with single cycle PA and two cyclic consecutive PA treatment according to clinical features at the time of diagnosis, laboratory findings, response and relapse rates. Complete Remission (CR) and Partial Remission (PR) were achieved with equal rates in both groups (90% and 10%, resp.). Relapse was observed in one patient in each group during the 69 months of median follow-up time. A patient who was treated with one cycle PA was exitus due to non-disease cause. The superiority of two consecutive cycle 2Cd-A administration could not be demonstrated in relation to the response and relapse rates. 2Cd-A is highly effective agent as a first-line treatment option with a high response rate.

Keywords:

Hairy Cell Leukemia, Cladribine, Prognosis,

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