BACKGROUND AND OBJECTIVE: In the 1980s alpha-interferon (alpha-IFN) dramatically improved the management of hairy cell leukemia (HCL), producing normalization of hematologic parameters including the disappearance of circulating hairy cells in the majority of treated patients, within 6 months. The quality and durability of the response depended on the duration of alpha-IFN treatment; progression of the disease consistently followed discontinuation of alpha-IFN. In this report, we examine the characteristics of long-term responders from our series of 44 HCL patients treated with alpha-IFN. METHODS: We report follow-up data on 44 HCL patients who underwent alpha-IFN as first-line treatment between 1985 and 1990. The alpha-IFN dose was 3 x 10(6) U daily for 12-15 months, with 20 patients continuing to receive the same dose three times a week as maintenance treatment for an additional 6-12 months. Of the 44 patients, 8 achieved a CR, 28 a PR and 8 a MR, with an overall response rate of 82%. Thirty-eight (86%) of these patients showed disease progression and were retreated with alpha-IFN (2 pts), 2-chlorodeoxyadenosine (35 pts), or pentostatin (1 pt). So far, all 38 patients are alive and in good unmaintained second response, except for two patients who developed a second neoplasm. RESULTS: Six of the 8 first complete responders are alive and have not required further treatment after completing alpha-IFN. These long responders most often (5/6) presented a hairy cell index (HCI) < 0.50 at diagnosis; all 6 registered a significant reduction in bone marrow infiltration (HCI < 0.10) after induction therapy and underwent alpha-IFN maintenance treatment. These three parameters turned out to be statistically significant when the long-term responders were compared with the failure patients subset (p = 0.003 for HCI at diagnosis; p = 0.001 for HCI at the end of the induction phase; p = 0.003 for the maintenance phase). The median progression-free survival of these 6 long-term responders was 75 months (range, 62 to 78). INTERPRETATION AND CONCLUSIONS: Overall, alpha-IFN represents an excellent palliative treatment for most HCL patients. A small subset of these patients could become long-term responders following first-line alpha-IFN therapy alone.

Adult↗

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[Analysis and therapy of recurrences of nonHodgkin lymphomas].

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Antineoplastic Agents↗

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Localized orbital lymphoma.

BACKGROUND AND OBJECTIVE: Localized orbital non Hodgkin's lymphoma is a rare event which has not been reported much in the literature. The aim of this study was to evaluate the clinical features, histology, treatment and clinical outcome of patients with localized orbital lymphoma. METHODS AND RESULTS: Fifteen patients with stage I-E orbital lymphoma diagnosed between 1975 and 1992 were reviewed. Diagnosis was formulated from 3-84 (median 23) months after the appearance of symptoms. Eight patients were males and 7 were females; median age was 55 years. The lacrimal gland was involved in 8 cases, the orbit in 7. Bilateral orbital localization was observed in only one patient. All cases were diagnosed as low-grade MALT lymphoma. Chemotherapy was administered in 7 patients, radiotherapy was employed in 7 and surgical excision was performed in the remaining case. Almost all the patients (14/15; 93%) achieved a complete remission (CR). Local relapse (LR) was observed in 3 cases but disease spread was never recorded. INTERPRETATION AND CONCLUSIONS: Correct histological diagnosis and careful staging are very important for the treatment and outcome of localized low-grade orbital lymphoma. These patients show a very good prognosis and radiation therapy alone is very effective in the treatment of this malignancy.

Adult↗