लक्षणयुक्त स्प्लेनोमेगाली और साइटोपेनिया के साथ क्लासिकल हेयरी-सेल ल्यूकेमिया का उपचार

References

DOI: 10.1093/annonc/mdv200

Treatment should be initiated in patients with symptomatic disease manifested by bulky or progressive, symptomatic splenomegaly cytopaenias (haemoglobin <10 g/dl and/or platelets <100 × 10⁹/l and/or neutrophils <1 × 10⁹/l), recurrent or severe infections and/or systemic symptoms [II, A] [17, 18].

Purine analogues, cladribine (2-CldA) or pentostatin (DCF), are recommended as initial treatment of symptomatic HCL patients who are young and fit (Figure 1) [II, A].

Fludarabine at a dose of 40 mg/m2 oral (p.o.) for five consecutive days in combination with an i.v. injection of 375 mg/m2 rituximab on day 1, every 28 days for four cycles, can be a therapeutic option in relapsed or refractory patients previously treated with 2-CldA [IV, B].

Bendamustine at 70–90 mg/m2 combined with rituximab is another therapeutic option in multiply relapsed/refractory HCL, and could be considered in HCL patients after the failure of standard therapies [IV, B] [43].