Relapsed or refractory Hairy Cell Leukemai: single agent Rituxan – pro
Most patient with hairy cell leukemai resond welkl to inital tehrapy but some do not,a and others relapse. ESMO does not recommend singel gent rituximab in such cases: ” Rituximab at a dose of 375 mg/m2 for 48 doses given weekly as i.v. infusions can be used in early relapsed patients [III, B] [3436]. However, rituximab alone is inferior to purine analogues and is not the treatment of choice as a single agent in relapsed patients. Outcomes for patients with recurrent HCL appear to be better when a combination of rituximab and 2-CldA or DCF is used rather than the purine analogue alone [III, B] [37, 38]. Concurrent therapy of rituximab and a purine analogue induces higher response rates, and higher rates of toxic events than in the sequential administration [III, B] “, and this recommendation is echoed by other guideline; instead it should be combined with other agents
T. Robak E. Matutes D. Catovsky P. L. Zinzani C. Buske on behalf of the ESMO Guidelines Committee Author Notes, Hairy cell leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, Volume 26, Issue suppl_5, 1 September 2015, Pages v100v107,
Michael R. Grever et al, Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia. Blood. 2017 Feb 2; 129(5): 553–560.