There are two main types of refractory myeloma patients:
Primary refractory patients who never achieve a response and progress while still on induction chemotherapy.
Secondary refractory patients who do respond to induction chemotherapy but do not respond to treatment after relapse.
A subgroup of patients who do not achieve a response to induction chemotherapy have stable disease and enjoy a survival prognosis that is as good as that for responding patients.[1,2] When the stable nature...
Progressive hairy cell leukemia, either postsplenectomy or postsystemic therapy.
Untreated hairy cell leukemia
Untreated hairy cell leukemia is characterized by splenomegaly, varying degrees of leukopenia (occasionally leukocytosis) and/or pancytopenia, and bone marrow infiltration by an atypical cell with prominent cytoplasmic projections (i.e., hairy cells). The bone marrow is usually fibrotic and is not easily aspirated. Bone marrow biopsies are, therefore, required for diagnosis and evaluation of the degree of hairy cell infiltration.
Progressive hairy cell leukemia
Progressive hairy cell leukemia, postsplenectomy (or following any systemic therapy) is characterized by progressive bone marrow replacement by hairy cells with pancytopenia refractory to treatment. For patients with advanced hairy cell leukemia treated with cladribine (2-chlorodeoxyadenosine, 2-CdA), pentostatin, or interferon-alpha, the survival rate appears to be more than 85% at 5 years following the initiation of any one of these therapies.[1,2]
Frassoldati A, Lamparelli T, Federico M, et al.: Hairy cell leukemia: a clinical review based on 725 cases of the Italian Cooperative Group (ICGHCL). Italian Cooperative Group for Hairy Cell Leukemia. Leuk Lymphoma 13 (3-4): 307-16, 1994.
Kurzrock R, Strom SS, Estey E, et al.: Second cancer risk in hairy cell leukemia: analysis of 350 patients. J Clin Oncol 15 (5): 1803-10, 1997.