TREATMENT OF HAIRY-CELL LEUKEMIA (HCL) WITH 2-CHLORODEOXYADENOSINE (2-CDA) - IDENTIFICATION OF PARAMETERS PREDICTIVE OF ADVERSE-EFFECTS

2-chlorodeoxyadenosine (2-CdA) induces high complete remission (CR) ra tes in hairy cell leukaemia (HCL), but is associated with serious toxi cities. Therefore we reviewed our experience with 2-CdA in 16 HCL pati ents, with special attention to adverse effects. One-third of patients presented severe neutropenic infections and/or required prolonged blo od support, Patients with low tumour mass and moderate cytopenias were more likely to achieve CR, whereas those with high tumour burden and severe bone marrow impairment were at increased risk of severe infecti on and brood product requirements. All these unfavourable parameters m ay be corrected by short-term alpha-interferon (IFN) therapy. Therefor e we suggest that patients with unfavourable presenting features might benefit from IFN therapy before 2-CdA.