Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia: An intergroup study

M. Grever, K. Kopecky, M. K. Foucar, D. Head, J. M. Bennett, R. E. Hutchison, W. E N Corbett, P. A. Cassileth, Thomas Matthew Habermann, H. Golomb, K. Rai, E. Eisenhauer, F. Appelbaum, B. D. Cheson

Research output: Contribution to journalArticle

216 Citations (Scopus)

Abstract

Purpose: Therapy of hairy cell leukemia has markedly improved. Interferon alfa-2a and pentostatin are active agents. The National Cancer Institute organized an intergroup trial to compare these agents prospectively in untreated patients. Methods: Patients were randomized to receive either interferon alfa-2a (3 x 106 U subcutaneously three times per week) or pentostatin (4 mg/m2 intravenously every 2 weeks). Patients who did not respond to initial treatment were crossed over. Results: Of 356 patients on study, 313 were eligible. Among interferon patients, 17 of 159 (11%) achieved a confirmed complete remission and 60 of 159 (38%) had a confirmed complete or partial remission. Among pentostatin patients, 117 of 154 (76%) achieved a confirmed complete remission and 121 of 154 (79%) had a confirmed complete or partial remission. Additional patients achieved criteria for complete remission, but lacked confirmatory follow-up evaluation. Response rates were significantly higher (P < .0001) and relapse-free survival was significantly longer with pentostatin than interferon (P < .0001). The median follow-up duration is 57 months (range, 19 to 82). Myelosuppression was more frequent with pentostatin (P = .013). A multivariate logistic regression analysis of the confirmed complete remissions on pentostatin showed the following factors to be important for achieving a complete remission: high hemoglobin level (two-tailed P = .024), young age (P = .0085), and no or little splenomegaly (P = .0029). Conclusion: Both agents were well tolerated. Pentostatin produced higher response rates, and the responses were durable. Patient age and clinical status had an impact on outcome with pentostatin. Pentostatin is effective therapy for hairy cell leukemia.

Original languageEnglish (US)
Pages (from-to)974-982
Number of pages9
JournalJournal of Clinical Oncology
Volume13
Issue number4
StatePublished - Apr 1995
Externally publishedYes

Fingerprint

Pentostatin
Hairy Cell Leukemia
Interferons
interferon alfa-2a
National Cancer Institute (U.S.)
Splenomegaly
Hemoglobins
Therapeutics
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Grever, M., Kopecky, K., Foucar, M. K., Head, D., Bennett, J. M., Hutchison, R. E., ... Cheson, B. D. (1995). Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia: An intergroup study. Journal of Clinical Oncology, 13(4), 974-982.

Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia : An intergroup study. / Grever, M.; Kopecky, K.; Foucar, M. K.; Head, D.; Bennett, J. M.; Hutchison, R. E.; Corbett, W. E N; Cassileth, P. A.; Habermann, Thomas Matthew; Golomb, H.; Rai, K.; Eisenhauer, E.; Appelbaum, F.; Cheson, B. D.

In: Journal of Clinical Oncology, Vol. 13, No. 4, 04.1995, p. 974-982.

Research output: Contribution to journalArticle

Grever, M, Kopecky, K, Foucar, MK, Head, D, Bennett, JM, Hutchison, RE, Corbett, WEN, Cassileth, PA, Habermann, TM, Golomb, H, Rai, K, Eisenhauer, E, Appelbaum, F & Cheson, BD 1995, 'Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia: An intergroup study', Journal of Clinical Oncology, vol. 13, no. 4, pp. 974-982.
Grever, M. ; Kopecky, K. ; Foucar, M. K. ; Head, D. ; Bennett, J. M. ; Hutchison, R. E. ; Corbett, W. E N ; Cassileth, P. A. ; Habermann, Thomas Matthew ; Golomb, H. ; Rai, K. ; Eisenhauer, E. ; Appelbaum, F. ; Cheson, B. D. / Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia : An intergroup study. In: Journal of Clinical Oncology. 1995 ; Vol. 13, No. 4. pp. 974-982.
@article{7996910ecc624ed4a11da350aedec006,
title = "Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia: An intergroup study",
abstract = "Purpose: Therapy of hairy cell leukemia has markedly improved. Interferon alfa-2a and pentostatin are active agents. The National Cancer Institute organized an intergroup trial to compare these agents prospectively in untreated patients. Methods: Patients were randomized to receive either interferon alfa-2a (3 x 106 U subcutaneously three times per week) or pentostatin (4 mg/m2 intravenously every 2 weeks). Patients who did not respond to initial treatment were crossed over. Results: Of 356 patients on study, 313 were eligible. Among interferon patients, 17 of 159 (11{\%}) achieved a confirmed complete remission and 60 of 159 (38{\%}) had a confirmed complete or partial remission. Among pentostatin patients, 117 of 154 (76{\%}) achieved a confirmed complete remission and 121 of 154 (79{\%}) had a confirmed complete or partial remission. Additional patients achieved criteria for complete remission, but lacked confirmatory follow-up evaluation. Response rates were significantly higher (P < .0001) and relapse-free survival was significantly longer with pentostatin than interferon (P < .0001). The median follow-up duration is 57 months (range, 19 to 82). Myelosuppression was more frequent with pentostatin (P = .013). A multivariate logistic regression analysis of the confirmed complete remissions on pentostatin showed the following factors to be important for achieving a complete remission: high hemoglobin level (two-tailed P = .024), young age (P = .0085), and no or little splenomegaly (P = .0029). Conclusion: Both agents were well tolerated. Pentostatin produced higher response rates, and the responses were durable. Patient age and clinical status had an impact on outcome with pentostatin. Pentostatin is effective therapy for hairy cell leukemia.",
author = "M. Grever and K. Kopecky and Foucar, {M. K.} and D. Head and Bennett, {J. M.} and Hutchison, {R. E.} and Corbett, {W. E N} and Cassileth, {P. A.} and Habermann, {Thomas Matthew} and H. Golomb and K. Rai and E. Eisenhauer and F. Appelbaum and Cheson, {B. D.}",
year = "1995",
month = "4",
language = "English (US)",
volume = "13",
pages = "974--982",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "4",

}

TY - JOUR

T1 - Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia

T2 - An intergroup study

AU - Grever, M.

AU - Kopecky, K.

AU - Foucar, M. K.

AU - Head, D.

AU - Bennett, J. M.

AU - Hutchison, R. E.

AU - Corbett, W. E N

AU - Cassileth, P. A.

AU - Habermann, Thomas Matthew

AU - Golomb, H.

AU - Rai, K.

AU - Eisenhauer, E.

AU - Appelbaum, F.

AU - Cheson, B. D.

PY - 1995/4

Y1 - 1995/4

N2 - Purpose: Therapy of hairy cell leukemia has markedly improved. Interferon alfa-2a and pentostatin are active agents. The National Cancer Institute organized an intergroup trial to compare these agents prospectively in untreated patients. Methods: Patients were randomized to receive either interferon alfa-2a (3 x 106 U subcutaneously three times per week) or pentostatin (4 mg/m2 intravenously every 2 weeks). Patients who did not respond to initial treatment were crossed over. Results: Of 356 patients on study, 313 were eligible. Among interferon patients, 17 of 159 (11%) achieved a confirmed complete remission and 60 of 159 (38%) had a confirmed complete or partial remission. Among pentostatin patients, 117 of 154 (76%) achieved a confirmed complete remission and 121 of 154 (79%) had a confirmed complete or partial remission. Additional patients achieved criteria for complete remission, but lacked confirmatory follow-up evaluation. Response rates were significantly higher (P < .0001) and relapse-free survival was significantly longer with pentostatin than interferon (P < .0001). The median follow-up duration is 57 months (range, 19 to 82). Myelosuppression was more frequent with pentostatin (P = .013). A multivariate logistic regression analysis of the confirmed complete remissions on pentostatin showed the following factors to be important for achieving a complete remission: high hemoglobin level (two-tailed P = .024), young age (P = .0085), and no or little splenomegaly (P = .0029). Conclusion: Both agents were well tolerated. Pentostatin produced higher response rates, and the responses were durable. Patient age and clinical status had an impact on outcome with pentostatin. Pentostatin is effective therapy for hairy cell leukemia.

AB - Purpose: Therapy of hairy cell leukemia has markedly improved. Interferon alfa-2a and pentostatin are active agents. The National Cancer Institute organized an intergroup trial to compare these agents prospectively in untreated patients. Methods: Patients were randomized to receive either interferon alfa-2a (3 x 106 U subcutaneously three times per week) or pentostatin (4 mg/m2 intravenously every 2 weeks). Patients who did not respond to initial treatment were crossed over. Results: Of 356 patients on study, 313 were eligible. Among interferon patients, 17 of 159 (11%) achieved a confirmed complete remission and 60 of 159 (38%) had a confirmed complete or partial remission. Among pentostatin patients, 117 of 154 (76%) achieved a confirmed complete remission and 121 of 154 (79%) had a confirmed complete or partial remission. Additional patients achieved criteria for complete remission, but lacked confirmatory follow-up evaluation. Response rates were significantly higher (P < .0001) and relapse-free survival was significantly longer with pentostatin than interferon (P < .0001). The median follow-up duration is 57 months (range, 19 to 82). Myelosuppression was more frequent with pentostatin (P = .013). A multivariate logistic regression analysis of the confirmed complete remissions on pentostatin showed the following factors to be important for achieving a complete remission: high hemoglobin level (two-tailed P = .024), young age (P = .0085), and no or little splenomegaly (P = .0029). Conclusion: Both agents were well tolerated. Pentostatin produced higher response rates, and the responses were durable. Patient age and clinical status had an impact on outcome with pentostatin. Pentostatin is effective therapy for hairy cell leukemia.

UR - http://www.scopus.com/inward/record.url?scp=0028929938&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028929938&partnerID=8YFLogxK

M3 - Article

C2 - 7707126

AN - SCOPUS:0028929938

VL - 13

SP - 974

EP - 982

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 4

ER -