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Robak T, Braun M, Guminska A, Iskierka-Jażdżewska E, Robak P. Successful treatment with cladribine in a patient with Rosai-Dorfman disease complicated by severe, prolonged marrow aplasia. Leuk Lymphoma 2024:1-6. [PMID: 38608253 DOI: 10.1080/10428194.2024.2340058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024]
Affiliation(s)
- Tadeusz Robak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
- Department of General Hematology, Copernicus Memorial Hospital, Lodz, Poland
| | - Marcin Braun
- Department of Pathology, Medical University of Lodz, Lodz, Poland
| | - Anna Guminska
- Department of Nuclear Medicine, Copernicus Memorial Hospital, Lodz, Poland
| | - Elżbieta Iskierka-Jażdżewska
- Department of Hematology, Medical University of Lodz, Lodz, Poland
- Department of General Hematology, Copernicus Memorial Hospital, Lodz, Poland
| | - Paweł Robak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
- Department of Hematooncology, Copernicus Memorial Hospital, Lodz, Poland
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Tefferi A, Kittur J, Farrukh F, Begna KH, Patnaik MM, Al-Kali A, Elliott MA, Reichard KK, Gangat N, Pardanani A. Cladribine therapy for advanced and indolent systemic mastocytosis: Mayo Clinic experience in 42 consecutive cases. Br J Haematol 2021; 196:975-983. [PMID: 34729775 DOI: 10.1111/bjh.17932] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 01/08/2023]
Abstract
We describe our single institution experience with cladribine therapy in 42 patients with systemic mastocytosis (SM): 22 advanced (adv-SM; median age 65 years, 68% males) and 20 indolent/smouldering SM (ISM/SSM; median age 56 years, 45% males); subcategories included eight aggressive, 13 associated with another haematological neoplasm, one mast cell leukaemia, 17 ISM and three SSM. Overall/major response rates were 77%/45% for adv-SM and 70%/60% for ISM/SSM, and median (range) duration of response 10 (4-75) and 46 (4-140) months respectively. A >50% reduction in bone marrow mast cell burden and serum tryptase level was documented in 63% and 67% of patients with adv-SM and 50% and 46% with ISM/SSM respectively. The presence of KIT proto-oncogene, receptor tyrosine kinase (KIT)D816V predicted response in adv-SM: 17 (90%) of 19 with and none of three without the mutation responded (P < 0·01). Treatment-emergent adverse events were mostly limited to transient cytopenias: Grade 3/4 neutropenia, thrombocytopenia, or lymphopenia occurred in 27%, 27% and 27% of patients with adv-SM, and 5%, 5% and 30% with ISM/SSM respectively. The present study provides practical information that might be considered when making treatment choices between cladribine and newer KIT-targeted therapies and identifies the absence of KITD816V as a potential marker of cladribine resistance in advanced SM; the latter observation needs confirmation in a larger study.
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Affiliation(s)
- Ayalew Tefferi
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jaya Kittur
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Faiqa Farrukh
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kebede H Begna
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mrinal M Patnaik
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Aref Al-Kali
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Michelle A Elliott
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kaaren K Reichard
- Division of Hematopathology, Department of Laboratory Medicine, Mayo Clinic, Rochester, MN, USA
| | - Naseema Gangat
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Animesh Pardanani
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Taniguchi M, Sakamoto K, Shioda Y, Doi T, Kudo K, Fujino H, Kudo K, Morimoto A. Salvage therapy with 2-chlorodeoxyadenosine for refractory and relapsed pediatric Langerhans cell histiocytosis: an updated nationwide survey in Japan. Int J Hematol 2021; 113:461-463. [PMID: 33564966 DOI: 10.1007/s12185-020-03073-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Maki Taniguchi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kenichi Sakamoto
- Children's Cancer Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Takehiko Doi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Ko Kudo
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hisanori Fujino
- Department of Pediatrics, Osaka Red Cross Hospital, Osaka, Japan
| | - Kazuko Kudo
- Department of Pediatrics, Fujita Health University, Toyoake, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan
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Néel A, Artifoni M, Fontenoy AM, Tessoulin B, Lorillon G, Cohen-Aubart F, Haroche J, Genereau T, de Menthon M, Guillevin L, Maillard H, Kahn JE, Hermine O, Araujo C, Dromer C, Jullien D, Hamidou M, Donadieu J, Tazi A. Long-term efficacy and safety of 2CdA (cladribine) in extra-pulmonary adult-onset Langerhans cell histiocytosis: analysis of 23 cases from the French Histiocytosis Group and systematic literature review. Br J Haematol 2020; 189:869-878. [PMID: 32191819 DOI: 10.1111/bjh.16449] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/08/2019] [Indexed: 12/11/2022]
Abstract
Langerhans cell histiocytosis (LCH) is a rare protean disease that usually affects children. Few data are available for management of adult-onset cases. A complete picture of the efficacy and safety of 2CdA (2-chlorodeoxyadenosine, cladribine) is lacking. We report a retrospective multicentre study of 23 adult LCH (a-LCH) patients who received single-agent 2CdA and a systematic literature review. All had previously received systemic therapy (vinblastine, n = 19). Response to 2CdA was evaluable in 22 cases. Overall response rate (ORR) was 91%. Complete response (CR) occurred in 11 cases (50%). Nine patients (39%) developed grade 3-4 neutropenia and/or severe infection. A literature review yielded 48 additional cases. A pooled analysis confirmed our findings (ORR: 88%, CR: 49%). CRs were rare with cumulative dose <50 mg/m2 . Disease progression rates were 20% and 30% at two and five years, respectively. Partial response (PR) to 2CdA was predictive of disease progression. Among eight re-treated patients, five went into CR, two in PR, and one died. Single-agent 2CdA is effective in reactivated a-LCH, including at intermediate doses. Toxicity, significant but acceptable, warrants infectious prophylaxis. Complete responders may enter prolonged remission. Further studies are needed to determine 2CdA sequencing with other agents (vinblastine, cytarabine).
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Affiliation(s)
- Antoine Néel
- Service de Médecine Interne, CHU de Nantes, Centre de compétence des Histiocytoses, Nantes, France
| | - Mathieu Artifoni
- Service de Médecine Interne, CHU de Nantes, Centre de compétence des Histiocytoses, Nantes, France
| | | | | | - Gwenaël Lorillon
- Service de Pneumologie, Assistance Publique-Hôpitaux de Paris, Centre National de Référence des Histiocytoses, Hôpital Saint-Louis, Paris, France
| | - Fleur Cohen-Aubart
- Service de Médecine Interne, Assistance Publique-Hôpitaux de Paris, Centre National de Référence des Histiocytoses, Hôpital Pitié-Salpêtrière, Paris, France
| | - Julien Haroche
- Service de Médecine Interne, Assistance Publique-Hôpitaux de Paris, Centre National de Référence des Histiocytoses, Hôpital Pitié-Salpêtrière, Paris, France
| | - Thierry Genereau
- Unité de Médecine Interne et Infectiologie, SELARL Loire Intermed, Nouvelles Cliniques Nantaises, site du Confluent, Nantes, France
| | - Mathilde de Menthon
- Service de Médecine Interne, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Loïc Guillevin
- Service de Médecine Interne, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Hélène Maillard
- Service de Médecine Interne, Centre Hospitalier Régional Universitaire, Lille, France
| | | | - Olivier Hermine
- Service d'Hématologie, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Carla Araujo
- Service d'Hématologie, Centre hospitalier de la Côte Basque, Bayonne, France
| | - Claire Dromer
- Service de Pneumologie, CHU de Bordeaux, Bordeaux, France
| | - Denis Jullien
- Service de Dermatologie, Hôpital Edouard Herriot, Lyon, France
| | - Mohamed Hamidou
- Service de Médecine Interne, CHU de Nantes, Centre de compétence des Histiocytoses, Nantes, France
| | - Jean Donadieu
- Centre National de Référence des Histiocytoses, Assistance Publique-Hôpitaux de Paris, Service d'Hémato-Oncologie Pédiatrique, Hôpital Trousseau, Paris, France
| | - Abdellatif Tazi
- Service de Pneumologie, Assistance Publique-Hôpitaux de Paris, Centre National de Référence des Histiocytoses, Hôpital Saint-Louis, Paris, France.,Inserm UMR-1153 (CRESS), Biostatistics and Clinical Epidemiology Research Team (ECSTRA), Univ Paris Diderot, Sorbonne Paris Cité, Paris, France
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Lapponi MJ, Britos CN, Rivero CW, Trelles JA. Biotransformation of cladribine using a stabilized biocatalyst in calcium alginate beads. Biotechnol Prog 2019; 36:e2927. [PMID: 31595721 DOI: 10.1002/btpr.2927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 12/23/2022]
Abstract
Cladribine is a nucleoside analogue widely used in the pharmaceutical industry for the treatment of several neoplasms, including hairy-cell leukemia among others. This compound has also shown efficacy in the treatment of autoimmune diseases such as rheumatoid arthritis and multiple sclerosis. In this work, a green bioprocess for cladribine biosynthesis using immobilized Arthrobacter oxydans was developed. The microorganism was stabilized by entrapment immobilization in the natural matrix alginate. Different reaction parameters were optimized obtaining a biocatalyst able to achieve cladribine bioconversion values close to 85% after 1 hr, the shortest reaction times reported so far. The developed bioprocess was successfully scaled-up reaching a productivity of 138 mg L-1 hr-1 . Also, the biocatalyst was stable for 5 months in storage and in 96 hr at operational conditions.
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Affiliation(s)
- María J Lapponi
- Laboratorio de Investigaciones en Biotecnología Sustentable (LIBioS), Universidad Nacional de Quilmes, Bernal, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), CABA, Argentina
| | - Claudia N Britos
- Laboratorio de Investigaciones en Biotecnología Sustentable (LIBioS), Universidad Nacional de Quilmes, Bernal, Argentina
| | - Cintia W Rivero
- Laboratorio de Investigaciones en Biotecnología Sustentable (LIBioS), Universidad Nacional de Quilmes, Bernal, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), CABA, Argentina
| | - Jorge A Trelles
- Laboratorio de Investigaciones en Biotecnología Sustentable (LIBioS), Universidad Nacional de Quilmes, Bernal, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), CABA, Argentina
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Briones NF, Hogikyan ND, Fullen DR, Silver SM, Do TT. Cutaneous and laryngopharyngeal papules of xanthoma disseminatum successfully treated with 2-chlorodeoxyadenosine. JAAD Case Rep 2018; 4:990-992. [PMID: 30417060 PMCID: PMC6218695 DOI: 10.1016/j.jdcr.2018.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
| | - Norman D. Hogikyan
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan
| | - Douglas R. Fullen
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Samuel M. Silver
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Thy Thy Do
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan
- Correspondence to: Thy Thy Do, MBBS, Clinical Assistant Professor, University of Michigan, Department of Dermatology, 1910 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109.
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Imashuku S, Shimazaki C, Tojo A, Imamura T, Morimoto A. Management of adult Langerhans cell histiocytosis based on the characteristic clinical features. World J Hematol 2013; 2:89-98. [DOI: 10.5315/wjh.v2.i3.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 05/10/2013] [Accepted: 06/06/2013] [Indexed: 02/05/2023] Open
Abstract
To find out the most appropriate management, clinical features of 18 cases of adult multisystem langerhans cell histiocytosis (LCH) have been analyzed. The patients comprising of 9 males and 9 females were median age of 36 years, ranging from 18-53 years at diagnosis. Regarding the initial symptoms, 7 patients (2 males and 5 females) showed central diabetes insipidus (CDI) and other endocrine symptoms with thickened pituitary stalk or a mass at the hypothalamic region. Additional 2 patients initiated the disease with CDI with no immediate diagnosis. In the remaining patients, the disease begun with single (n = 3) or multiple (n = 1) spinal bone lesion(s) in 4 patients (all males), with multiple bone lesions in 3 patients (1 male and 2 females), with single skull lesion in one female patient and with ambiguous symptoms including hypothyroidism in the remaining one male patient. We also recognized the correlation between pregnancy/childbirth and LCH in 4 patients. In terms of treatment, 9 patients received systemic immuno-chemotherapy alone, of which the majority received vinblastine-based chemotherapy while 4 received 2-chlorodeoxyadenosine. Five had a combination of immuno-chemotherapy with surgical resection or radiotherapy, 2 had immunotherapy alone, 2 had surgical resection followed by observation alone to date. Three patients received hematopoietic stem cell transplantation after extensive chemotherapy. In terms of outcome, 15 patients are alive (9 with active disease, 6 without active disease), with a median of 66 mo (range 17-166 mo), two died of disease while the remaining 1 lost to follow-up. Based on these results, we think that early diagnosis and rapid introduction of appropriate treatment are essential, in order to overcome the problems relevant to adult LCH.
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Krstevska S, Genadieva-Stavric S, Sotirova T, Spasovski D, Balkanov T. Hairy cell leukemia treatment: where we are now? Mater Sociomed 2011; 23:227-9. [PMID: 23678301 PMCID: PMC3633398 DOI: 10.5455/msm.2011.23.227-229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2011] [Accepted: 09/10/2011] [Indexed: 11/30/2022] Open
Abstract
Hairy cell leukemia (HCL) is a very rare type of leukemia, in which abnormal B lymphocytes, present in the bone marrow, spleen, and peripheral blood stream, get worse slowly or do not get worse at all. HCL is the disease where patients have pancytopenia with splenomegalia over 90% percent, palpable lymphadenopathy occur in 35% of patients, some form of serious infection eventually developed in over 50% of patients and was the most common cause of death in patients. HCL is dominantly a male disease, with the male-female ratio, ranging from 4:1 to 7:1. Treatment and prognosis of HCL depends on: the number of HC in the peripheral blood or bone marrow, if the spleen is enlarged and on the existence of the visible leukemia infection symptoms. Prognostic factors are similar to the above mentioned and also if the basic disease HCL is aggressive or the number of HC grow slowly and there is no need for treatment. Starting from September 1985 till September 2010, we observed a group with total number of 28 patients (22 males and 6 females) at the age of 30-76 (median range 46 years), all with HCL disease. From the total number of participants, 20 patients (71,43%) received hemotherapy, Cladribine and 8 patients (28,57%) received different type of therapy, such as immunomodulator therapy, surgery or combination of both, without Cladribine. Most effective therapy for HCL, from all of the above mentioned was definitely Cladribine which is dominant with a resulting response rates of 80-100%, where 70-90% of patients were achieving a complete remission, as defined by a complete disappearance of hairy cells in the bone marrow.
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Affiliation(s)
- Svetlana Krstevska
- Hematology Clinic, Clinical center of University of Skopje, Republic of Macedonia
| | | | - Tatjana Sotirova
- Hematology Clinic, Clinical center of University of Skopje, Republic of Macedonia
| | - Dejan Spasovski
- Rheumatology Clinic, Clinical center of University of Skopje, Republic of Macedonia
| | - Trajan Balkanov
- Department of Pharmacology, Medical faculty University “St Ciril and Methodius” Skopje, Republic of Macedonia
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