Hairy cell leukemia

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Last updated on 2024-07-23:12 regimens on this page
17 variants on this page
=Guidelines=
Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.
==ESMO==
*2015: Robak et al. Hairy cell leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up EuroPMC
==Hairy Cell Leukemia Foundation==
*2017: Grever et al. Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia EuroPMC
==NCCN==
*NCCN Guidelines - Hairy Cell Leukemia
**2017: Wierda et al. Hairy Cell Leukemia, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology EuroPMC
=Untreated=
==Cladribine monotherapy==
===Regimen variant #1, 0.09 mg/kg/day x 7 days===
Study 	Dates of enrollment	Evidence
Saven et al. 1998	1986-1993 	Non-randomized (RT)
====Chemotherapy====
*Cladribine (Leustatin) 0.09 mg/kg/day IV continuous infusion over 7 days, started on day 1 (total dose: 0.63 mg/kg)
7-day course
===Regimen variant #2, 0.1 mg/kg/day x 7 days===
Study 	Dates of enrollment	Evidence
Piro et al. 1990 	1986-1989 	Pilot, fewer than 20 pts
Tallman et al. 1996	1991-1995 	Phase 2
====Chemotherapy====
*Cladribine (Leustatin) 0.1 mg/kg/day IV continuous infusion over 7 days, started on day 1 (total dose: 0.7 mg/kg)
7-day course
===Regimen variant #3, 0.12 mg/kg/day x 5 days=== 
Study 	Dates of enrollment	Evidence 	Comparator 	Comparative Efficacy
Robak et al. 1999	1991-1997 	Phase 2 	 	
Robak et al. 2007	1998-2005 	Phase 3 (C)	Cladribine; weekly	Did not meet primary endpoint of CR rate
====Chemotherapy====
*Cladribine (Leustatin) 0.12 mg/kg IV over 2 hours once per day on days 1 to 5
5-day course
===Regimen variant #4, 0.14 mg/kg/day x 5 days===
Study 	Dates of enrollment	Evidence 	Comparator 	Comparative Efficacy
Zenhäusern et al. 2009 (SAKK 32/98)	1998-2005 	Phase 3 (C)	Cladribine; weekly	Did not meet primary endpoint of average leukocyte count within 6 weeks from randomization
====Chemotherapy====
*Cladribine (Leustatin) 0.14 mg/kg SC once per day on days 1 to 5
5-day course
===Regimen variant #5, 0.15 mg/kg/day x 5 days=== 
Study 	Dates of enrollment 	Evidence
Damasio et al. 1998	Not reported in abstract	Phase 2
Note: The full manuscript was not available for review.
====Chemotherapy====
*Cladribine (Leustatin) 0.15 mg/kg IV over 2 hours once per day on days 1 to 5
5-day course
===References===
# Piro LD, Carrera CJ, Carson DA, Beutler E. Lasting remissions in hairy-cell leukemia induced by a single infusion of 2-chlorodeoxyadenosine. N Engl J Med. 1990 Apr 19;322(16):1117-21. link to original article dosing details in abstract have been reviewed by our editors EuroPMC
# Tallman MS, Hakimian D, Rademaker AW, Zanzig C, Wollins E, Rose E, Peterson LC. Relapse of hairy cell leukemia after 2-chlorodeoxyadenosine: long-term follow-up of the Northwestern University experience. Blood. 1996 Sep 15;88(6):1954-9. link to original article dosing details in manuscript have been reviewed by our editors EuroPMC
## Update: Chadha P, Rademaker AW, Mendiratta P, Kim B, Evanchuk DM, Hakimian D, Peterson LC, Tallman MS. Treatment of hairy cell leukemia with 2-chlorodeoxyadenosine (2-CdA): long-term follow-up of the Northwestern University experience. Blood. 2005 Jul 1;106(1):241-6. Epub 2005 Mar 10. link to original article dosing details in abstract have been reviewed by our editors EuroPMC content property of HemOnc.org
# Damasio EE, Resegotti L, Masoudi B, Bruni R, Cerri R, Isaza A, Clavio M, Risso M, Rossi E, Spriano M, Truini M; Italian Group for the Hairy Cell Leukemia. Five day intermittent vs seven day continuous 2-chlorodeoxyadenosine infusion for the treatment of hairy cell leukemia: a study by Italian Group for the Hairy Cell Leukemia. Recenti Prog Med. 1998 Feb;89(2):68-73. EuroPMC
# Saven A, Burian C, Koziol JA, Piro LD. Long-term follow-up of patients with hairy cell leukemia after cladribine treatment. Blood. 1998 Sep 15;92(6):1918-26. link to original article EuroPMC
# Robak T, Błasińska-Morawiec M, Błoński J, Hellmann A, Hałaburda K, Konopka L, Kotlarek-Haus S, Potoczek S, Hansz J, Dmoszyńska A, Urasiński I, Zdziarska B, Dwilewicz-Trojaczek J, Hołowiecki J, Skotnicki AB. 2-chlorodeoxyadenosine (cladribine) in the treatment of hairy cell leukemia and hairy cell leukemia variant: 7-year experience in Poland. Eur J Haematol. 1999 Jan;62(1):49-56. link to original article EuroPMC
# Robak T, Jamroziak K, Gora-Tybor J, Blonski JZ, Kasznicki M, Dwilewicz-Trojaczek J, Wiater E, Zdunczyk A, Dybowicz J, Dmoszynska A, Wojtaszko M, Zdziarska B, Calbecka M, Kostyra A, Hellmann A, Lewandowski K, Stella-Holowiecka B, Sulek K, Gawronski K, Skotnicki AB, Nowak W, Zawilska K, Molendowicz-Portala L, Kloczko J, Sokolowski J, Warzocha K, Seferynska I, Ceglarek B, Konopka L; PALG. Cladribine in a weekly versus daily schedule for untreated active hairy cell leukemia: final report from the Polish Adult Leukemia Group (PALG) of a prospective, randomized, multicenter trial. Blood. 2007 May 1;109(9):3672-5. Epub 2007 Jan 5. link to original article dosing details in manuscript have been reviewed by our editors EuroPMC
# SAKK 32/98: Zenhäusern R, Schmitz SF, Solenthaler M, Heim D, Meyer-Monard S, Hess U, Leoncini L, Bargetzi M, Rufener B, Tobler A. Randomized trial of daily versus weekly administration of 2-chlorodeoxyadenosine in patients with hairy cell leukemia: a multicenter phase III trial (SAKK 32/98). Leuk Lymphoma. 2009 Sep;50(9):1501-11. link to original article dosing details in manuscript have been reviewed by our editors EuroPMC NCT00003746
==Cladribine & Rituximab==
===Regimen===
Study 	Dates of enrollment	Evidence
Ravandi et al. 2011	2004-2009 	Phase 2
Note: 28 days after administration of cladribine, bone marrow examination was repeated, and then rituximab was started.
====Chemotherapy, first portion (course 1)====
*Cladribine (Leustatin) 5.6 mg/m2 IV over 2 hours once per day on days 1 to 5
====Supportive therapy, first portion (course 1)====
All were administered at the discretion of the treating physician.
*Levofloxacin (Levaquin)
*Valacyclovir (Valtrex)
*Fluconazole (Diflucan)
*Filgrastim (Neupogen)
====Targeted therapy, second portion (cycles 2 to 9)====
*Rituximab (Rituxan) 375 mg/m2 IV once on day 1
28-day course, then 7-day cycle for 8 cycles
===References===
# Ravandi F, O'Brien S, Jorgensen J, Pierce S, Faderl S, Ferrajoli A, Koller C, Challagundla P, York S, Brandt M, Luthra R, Burger J, Thomas D, Keating M, Kantarjian H. Phase 2 study of cladribine followed by rituximab in patients with hairy cell leukemia. Blood. 2011 Oct 6;118(14):3818-23. Epub 2011 Aug 5. link to original article dosing details in manuscript have been reviewed by our editors link to PMC article EuroPMC
## Update: Chihara D, Kantarjian H, O'Brien S, Jorgensen J, Pierce S, Faderl S, Ferrajoli A, Poku R, Jain P, Thompson P, Brandt M, Luthra R, Burger J, Keating M, Ravandi F. Long-term durable remission by cladribine followed by rituximab in patients with hairy cell leukaemia: update of a phase II trial. Br J Haematol. 2016 Sep;174(5):760-6. Epub 2016 Jun 15. link to original article link to PMC article EuroPMC
==Interferon alfa-2a monotherapy==
===Regimen=== 
Study 	Dates of enrollment	Evidence 	Comparator 	Comparative Efficacy
Grever et al. 1995 (SWOG 8691)	1986-1989 	Phase 3 (C)	Pentostatin	Shorter RFS (co-primary endpoint)
====Immunotherapy====
*Interferon alfa-2a (Roferon-A) 3,000,000 units SC once per day on days 1, 3, 5 (3 times per week)
7-day cycle for 26 cycles
===References===
# SWOG 8691: Grever M, Kopecky K, Foucar MK, Head D, Bennett JM, Hutchison RE, Corbett WE, Cassileth PA, Habermann T, Golomb H, Rai K, Eisenhauer E, Appelbaum F, Cheson BD. Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia: an intergroup study. J Clin Oncol. 1995 Apr;13(4):974-82. link to original article dosing details in manuscript have been reviewed by our editors EuroPMC
## Update: Flinn IW, Kopecky KJ, Foucar MK, Head D, Bennett JM, Hutchison R, Corbett W, Cassileth P, Habermann T, Golomb H, Rai K, Eisenhauer E, Appelbaum F, Cheson B, Grever MR. Long-term follow-up of remission duration, mortality, and second malignancies in hairy cell leukemia patients treated with pentostatin. Blood. 2000 Nov 1;96(9):2981-6. link to original article EuroPMC
==Pentostatin monotherapy==
===Regimen variant #1=== 
Study 	Dates of enrollment	Evidence
Spiers et al. 1987	1984-1987 	Non-randomized
====Chemotherapy====
*Pentostatin (Nipent) 5 mg/m2 IV over 2 minutes once per day on days 1 & 2
14-day cycles, continued to the point of maximal response or treatment failure
===Regimen variant #2===
Study 	Dates of enrollment	Evidence 	Comparator 	Comparative Efficacy
Grever et al. 1995 (SWOG 8691)	1986-1989 	Phase 3 (E-RT-switch-ooc)	Interferon alfa-2a	Longer RFS (co-primary endpoint)
Note: patients who had complete response before 6 months were given 2 additional cycles of pentostatin, and then treatment was stopped. Patients with objective partial response after 6 months of treatment received an additional 6 months of additional therapy, until they had a complete response or progression of disease.
====Chemotherapy====
*Pentostatin (Nipent) 4 mg/m2 IV rapid injection once on day 1
====Supportive therapy====
*1.5 liters of IV fluid hydration with every dose
14-day cycles (see note)
====Dose and schedule modifications====
*Patients with performance status of 3 received an initial dose of 2 mg/m2 IV rapid injection once on day 1, which would be increased in later cycles to 4 mg/m2 IV rapid injection once on day 1 if patients had no adverse reactions.
*Doses of pentostatin were held for patients who had an increase in the serum creatinine concentration greater than 20% above their baseline. Pentostatin was not given until renal function returned to baseline or if 24-hour creatinine clearance was greater than 50 mL/min/1.73m2.
===References===
# Spiers AS, Moore D, Cassileth PA, Harrington DP, Cummings FJ, Neiman RS, Bennett JM, O'Connell MJ; ECOG. Remissions in hairy-cell leukemia with pentostatin (2'-deoxycoformycin). N Engl J Med. 1987 Apr 2;316(14):825-30. link to original article dosing details in manuscript have been reviewed by our editors EuroPMC
## Update: Cassileth PA, Cheuvart B, Spiers AS, Harrington DP, Cummings FJ, Neiman RS, Bennett JM, O'Connell MJ. Pentostatin induces durable remissions in hairy cell leukemia. J Clin Oncol. 1991 Feb;9(2):243-6. link to original article dosing details in abstract have been reviewed by our editors EuroPMC
# SWOG 8691: Grever M, Kopecky K, Foucar MK, Head D, Bennett JM, Hutchison RE, Corbett WE, Cassileth PA, Habermann T, Golomb H, Rai K, Eisenhauer E, Appelbaum F, Cheson BD. Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia: an intergroup study. J Clin Oncol. 1995 Apr;13(4):974-82. link to original article dosing details in manuscript have been reviewed by our editors EuroPMC
## Update: Flinn IW, Kopecky KJ, Foucar MK, Head D, Bennett JM, Hutchison R, Corbett W, Cassileth P, Habermann T, Golomb H, Rai K, Eisenhauer E, Appelbaum F, Cheson B, Grever MR. Long-term follow-up of remission duration, mortality, and second malignancies in hairy cell leukemia patients treated with pentostatin. Blood. 2000 Nov 1;96(9):2981-6. link to original article dosing details in manuscript have been reviewed by our editors EuroPMC
=Relapsed or refractory=
==Bendamustine & Rituximab (BR)==
BR: Bendamustine, Rituximab
===Regimen===
Study 	Dates of enrollment	Evidence
Burotto et al. 2013	Not reported 	Pilot, fewer than 20 patients
Note: this was a dose-escalation study and the bendamustine dose was selected for further study based on absence of DLT.
====Chemotherapy====
*Bendamustine 90 mg/m2 IV once per day on days 1 & 2
====Targeted therapy====
*Rituximab (Rituxan) 375 mg/m2 IV once per day on days 1 & 15
28-day cycle for 6 cycles
===References===
# Burotto M, Stetler-Stevenson M, Arons E, Zhou H, Wilson W, Kreitman RJ. Bendamustine and rituximab in relapsed and refractory hairy cell leukemia. Clin Cancer Res. 2013 Nov 15;19(22):6313-21. Epub 2013 Oct 28. link to original article link to PMC article dosing details in manuscript have been reviewed by our editors EuroPMC
==Cladribine & Rituximab==
===Regimen===
Study 	Dates of enrollment	Evidence
Ravandi et al. 2011	2004-2009 	Phase 2, fewer than 20 pts in this cohort
Note: 28 days after administration of cladribine, bone marrow examination was repeated, and then rituximab was started.
====Chemotherapy, first portion (course 1)====
*Cladribine (Leustatin) 5.6 mg/m2 IV over 2 hours once per day on days 1 to 5
====Supportive therapy, first portion (course 1)====
All were administered at the discretion of the treating physician.
*Levofloxacin (Levaquin)
*Valacyclovir (Valtrex)
*Fluconazole (Diflucan)
*Filgrastim (Neupogen)
====Targeted therapy, second portion (cycles 2 to 9)====
*Rituximab (Rituxan) 375 mg/m2 IV once on day 1
28-day course, then 7-day cycle for 8 cycles
===References===
# Ravandi F, O'Brien S, Jorgensen J, Pierce S, Faderl S, Ferrajoli A, Koller C, Challagundla P, York S, Brandt M, Luthra R, Burger J, Thomas D, Keating M, Kantarjian H. Phase 2 study of cladribine followed by rituximab in patients with hairy cell leukemia. Blood. 2011 Oct 6;118(14):3818-23. Epub 2011 Aug 5. link to original article dosing details in manuscript have been reviewed by our editors link to PMC article EuroPMC
## Update: Chihara D, Kantarjian H, O'Brien S, Jorgensen J, Pierce S, Faderl S, Ferrajoli A, Poku R, Jain P, Thompson P, Brandt M, Luthra R, Burger J, Keating M, Ravandi F. Long-term durable remission by cladribine followed by rituximab in patients with hairy cell leukaemia: update of a phase II trial. Br J Haematol. 2016 Sep;174(5):760-6. Epub 2016 Jun 15. link to original article link to PMC article EuroPMC
==Interferon alfa-2a monotherapy==
===Regimen===
Study 	Dates of enrollment 	Evidence
Quesada et al. 1986 (N2752)	1984 to not reported	Non-randomized (RT)
Note: This is of historic interest. It is not completely clear whether the cited study is the same as N2752, which is cited by the FDA in the package insert.
====Immunotherapy====
*Interferon alfa-2a (Roferon-A)
===References===
#N2752: Quesada JR, Hersh EM, Manning J, Reuben J, Keating M, Schnipper E, Itri L, Gutterman JU. Treatment of hairy cell leukemia with recombinant alpha-interferon. Blood. 1986 Aug;68(2):493-7. link to original article EuroPMC
==Interferon alfa-2b monotherapy==
===Regimen===
Study 	Dates of enrollment	Evidence 	Comparator 	Comparative Efficacy	Comparative Toxicity
Quesada et al. 1984	Not reported 	Pilot, fewer than 20 pts	 	 	
Golomb et al. 1986 	1983-1984 	Non-randomized 	 	 	
Golomb et al. 1988 	1985-1987 	Randomized (E-RT-de-esc)	Inteferon alfa-2b x 18 mo	 	Seems to have lower incidence of fatigue
Note: This is of historic interest. Most patients had previously undergone splenectomy.
====Immunotherapy====
*Interferon alfa-2b (Intron-A) 2,000,000 units SC three times per week
12-month course
===References===
# Quesada JR, Reuben J, Manning JT, Hersh EM, Gutterman JU. Alpha interferon for induction of remission in hairy-cell leukemia. N Engl J Med. 1984 Jan 5;310(1):15-8. link to original article EuroPMC
# Golomb HM, Jacobs A, Fefer A, Ozer H, Thompson J, Portlock C, Ratain M, Golde D, Vardiman J, Burke JS, Brady J, Bonnem E, Spiegel R. Alpha-2 interferon therapy of hairy-cell leukemia: a multicenter study of 64 patients. J Clin Oncol. 1986 Jun;4(6):900-5. link to original article EuroPMC
# Golomb HM, Ratain MJ, Fefer A, Thompson J, Golde DW, Ozer H, Portlock C, Silber R, Rappeport J, Bonnem E, Spiegel R, Tensen L, Burke JS, Vardiman JW. Randomized study of the duration of treatment with interferon alfa-2B in patients with hairy cell leukemia. J Natl Cancer Inst. 1988 May 4;80(5):369-73. link to original article EuroPMC
==Moxetumomab pasudotox monotherapy==
===Regimen===
FDA-recommended dose
Study 	Dates of enrollment	Evidence
Kreitman et al. 2018 (Study 1053)	2013-2016 	Phase 2 (RT)
====Targeted therapy====
*Moxetumomab pasudotox (Lumoxiti) 0.04 mg/kg IV over 30 minutes once per day on days 1, 3, 5
28-day cycle for up to 6 cycles
===References===
# Study 1053: Kreitman RJ, Dearden C, Zinzani PL, Delgado J, Karlin L, Robak T, Gladstone DE, le Coutre P, Dietrich S, Gotic M, Larratt L, Offner F, Schiller G, Swords R, Bacon L, Bocchia M, Bouabdallah K, Breems DA, Cortelezzi A, Dinner S, Doubek M, Gjertsen BT, Gobbi M, Hellmann A, Lepretre S, Maloisel F, Ravandi F, Rousselot P, Rummel M, Siddiqi T, Tadmor T, Troussard X, Yi CA, Saglio G, Roboz GJ, Balic K, Standifer N, He P, Marshall S, Wilson W, Pastan I, Yao NS, Giles F. Moxetumomab pasudotox in relapsed/refractory hairy cell leukemia. Leukemia. 2018 Aug;32(8):1768-1777. Epub 2018 Jul 20. link to original article link to PMC article dosing details in abstract have been reviewed by our editors EuroPMC NCT01829711
## Update: Kreitman RJ, Dearden C, Zinzani PL, Delgado J, Robak T, le Coutre PD, Gjertsen BT, Troussard X, Roboz GJ, Karlin L, Gladstone DE, Kuptsova-Clarkson N, Liu S, Patel P, Rotolo F, Mitry E, Pastan I, Giles F; Study 1053 investigators. Moxetumomab pasudotox in heavily pre-treated patients with relapsed/refractory hairy cell leukemia (HCL): long-term follow-up from the pivotal trial. J Hematol Oncol. 2021 Feb 24;14(1):35. link to original article link to PMC article EuroPMC
==Rituximab monotherapy==
===Regimen===
Study 	Dates of enrollment	Evidence
Nieva et al. 2003	2000-2002 	Phase 2
====Targeted therapy====
*Rituximab (Rituxan) 375 mg/m2 IV once per day on days 1, 8, 15, 22
====Supportive therapy====
*Allopurinol (Zyloprim) 300 mg PO once per day on days 1 to 7
4-week course
===References===
# Nieva J, Bethel K, Saven A. Phase 2 study of rituximab in the treatment of cladribine-failed patients with hairy cell leukemia. Blood. 2003 Aug 1;102(3):810-3. Epub 2003 Mar 27. link to original article dosing details in manuscript have been reviewed by our editors EuroPMC
==Vemurafenib monotherapy==
===Regimen===
Study 	Dates of enrollment	Evidence	Efficacy
Tiacci et al. 2015 (MSKCC 12-200)	2013-2015 	Phase 2 	ORR: 96-100%
Tiacci et al. 2015 (HCL-PG01) 	2013-2015 	Phase 2 	ORR: 96-100%
Note: a pooled analysis of two phase 2 trials is reported in Tiacci et al. 2015; they have slightly different durations - please see original text for details.
====Targeted therapy====
*Vemurafenib (Zelboraf) 960 mg PO twice per day on days 1 to 28
28-day cycle for varying durations: 4 cycles (HCL-PG01); 6 cycles (MSKCC 12-200)
===References===
# MSKCC 12-200: Tiacci E, Park JH, De Carolis L, Chung SS, Broccoli A, Scott S, Zaja F, Devlin S, Pulsoni A, Chung YR, Cimminiello M, Kim E, Rossi D, Stone RM, Motta G, Saven A, Varettoni M, Altman JK, Anastasia A, Grever MR, Ambrosetti A, Rai KR, Fraticelli V, Lacouture ME, Carella AM, Levine RL, Leoni P, Rambaldi A, Falzetti F, Ascani S, Capponi M, Martelli MP, Park CY, Pileri SA, Rosen N, Foà R, Berger MF, Zinzani PL, Abdel-Wahab O, Falini B, Tallman MS. Targeting mutant BRAF in relapsed or refractory hairy-cell leukemia. N Engl J Med. 2015 Oct 29;373(18):1733-47. Epub 2015 Sep 9. link to original article dosing details in manuscript have been reviewed by our editors link to PMC article EuroPMC NCT01711632
# HCL-PG01: Tiacci E, Park JH, De Carolis L, Chung SS, Broccoli A, Scott S, Zaja F, Devlin S, Pulsoni A, Chung YR, Cimminiello M, Kim E, Rossi D, Stone RM, Motta G, Saven A, Varettoni M, Altman JK, Anastasia A, Grever MR, Ambrosetti A, Rai KR, Fraticelli V, Lacouture ME, Carella AM, Levine RL, Leoni P, Rambaldi A, Falzetti F, Ascani S, Capponi M, Martelli MP, Park CY, Pileri SA, Rosen N, Foà R, Berger MF, Zinzani PL, Abdel-Wahab O, Falini B, Tallman MS. Targeting mutant BRAF in relapsed or refractory hairy-cell leukemia. N Engl J Med. 2015 Oct 29;373(18):1733-47. Epub 2015 Sep 9. link to original article dosing details in manuscript have been reviewed by our editors link to PMC article EuroPMC EudraCT 2011-005487-13
=Hairy cell leukemia variant (HCLv), all lines of therapy=
Note: this is a distinct disease process from hairy cell leukemia, but will be included on this page for now given the similarities. We may create a dedicated page in the future.
==Cladribine & Rituximab==
===Regimen===
Study 	Dates of enrollment	Evidence
Ravandi et al. 2011	2004-2009 	Phase 2, fewer than 20 pts in this cohort
Note: 28 days after administration of cladribine, bone marrow examination was repeated, and then rituximab was started.
====Chemotherapy, first portion (course 1)====
*Cladribine (Leustatin) 5.6 mg/m2 IV over 2 hours once per day on days 1 to 5
====Supportive therapy, first portion (course 1)====
All were administered at the discretion of the treating physician.
*Levofloxacin (Levaquin)
*Valacyclovir (Valtrex)
*Fluconazole (Diflucan)
*Filgrastim (Neupogen)
====Targeted therapy, second portion (cycles 2 to 9)====
*Rituximab (Rituxan) 375 mg/m2 IV once on day 1
28-day course, then 7-day cycle for 8 cycles
===References===
# Ravandi F, O'Brien S, Jorgensen J, Pierce S, Faderl S, Ferrajoli A, Koller C, Challagundla P, York S, Brandt M, Luthra R, Burger J, Thomas D, Keating M, Kantarjian H. Phase 2 study of cladribine followed by rituximab in patients with hairy cell leukemia. Blood. 2011 Oct 6;118(14):3818-23. Epub 2011 Aug 5. link to original article dosing details in manuscript have been reviewed by our editors link to PMC article EuroPMC
## Update: Chihara D, Kantarjian H, O'Brien S, Jorgensen J, Pierce S, Faderl S, Ferrajoli A, Poku R, Jain P, Thompson P, Brandt M, Luthra R, Burger J, Keating M, Ravandi F. Long-term durable remission by cladribine followed by rituximab in patients with hairy cell leukaemia: update of a phase II trial. Br J Haematol. 2016 Sep;174(5):760-6. Epub 2016 Jun 15. link to original article link to PMC article EuroPMC
Category:Hairy cell leukemia regimens
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Category:Indolent lymphomas