Hairy cell leukemia (HCL) with extensive myelofibrosis responds to thalidomide.

Abstract

We present a 75-year-old man who was admitted to our hospital because of splenomegaly, transfusion-dependent anemia and thrombocytopenia. The diagnosis of idiopathic myelofibrosis was suggested by the bone marrow trephine biopsy, which was hypocellular with myelofibrosis. Thalidomide was started at a daily dose of 100 mg/d and increased to 400 mg/d. Within 12 weeks, thrombocytes increased to 100.000/microl, hemoglobin normalized, lasting for about 11 months. Then, thalidomide had to be discontinued because of mild polyneuropathy. A second bone marrow biopsy showed fibrosis as well as a diffuse infiltration of the bone marrow (80%) by lymphocytes with expression of CD11c, CD19, CD20, CD103. Tartrate resistant acid phosphatase test (TRAP) was also positive. Hairy cell leukemia was diagnosed and he was administered 2-chlorodeoxyadenosine (2-CDA) achieving a complete remission.

• Authors: C Strupp, R Fenk, A Kündgen, N Gattermann, R Haas, U Germing
• Journal: Leukemia research (Leuk Res) Vol. 29 Issue 8 Pg. 967-9 (Aug 2005) ISSN: 0145-2126 [Print] England
• PMID: 15978949 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Cladribine
• Thalidomide

Topics

• Aged
• Cladribine (administration & dosage, therapeutic use)
• Humans
• Leukemia, Hairy Cell (complications, diagnosis, drug therapy)
• Male
• Primary Myelofibrosis (complications, diagnosis, drug therapy)
• Remission Induction
• Thalidomide (adverse effects, therapeutic use)
• Treatment Outcome