Understanding Standard Chemotherapy in Hairy Cell Leukemia
Purine analogs - pentostatin and cladribine - have been the go-to treatment for Hairy Cell Leukemia (HCL) for over thirty years. Purine analogs have dramatically improved survival for patients. Before we developed these drugs, most patients with HCL died, and the disease was considered incurable. Today, someone diagnosed with HCL can live as long as their peers who do not have HCL.
Pentostatin emerged in the 1980s, with cladribine following in the early 1990s. Plenty of long-term data back the effectiveness of these therapies. They both induce clinical responses and remissions in most patients without significant differences between them. So, if patients cannot tolerate cladribine, they could consider pentostatin, and vice versa.
In the United States, doctors administer these drugs intravenously. Subcutaneous cladribine is available in other countries.
While cladribine or pentostatin monotherapy is often the first-line treatment for new patients with classic HCL, doctors can combine these drugs with monoclonal antibodies, such as rituximab. The combination is an appropriate regimen when a patient relapses after the first treatment with purine analogs monotherapy, and increasingly, patients opt for the combination as their first treatment after the initial diagnosis.
Since the development of purine analogs 30 years ago, researchers have developed other options for patients with HCL who don't respond well to purine analogs; new research and treatment options continue to give patients new hope.
Check out these sources on pentostatin and cladribine as well as other options for treatment: