| Title | Approach to the patient after relapse of hairy cell leukemia. | | Author(s) | Kreitman RJ, Fitzgerald DJ, Pastan I | | Institution | Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA. kreitmar@mail.nih.gov | | Source | Leuk Lymphoma 2009 Oct.:32-7. | | Abstract | The current hairy cell leukemia (HCL) treatment is excellent, but evidence of cure with purine analogs cladribine and pentostatin, is lacking. Significant long-term immune suppression, particularly to CD4+ T-cells, and declining complete remission rates with each course, make the identification of new therapies an important goal. The anti-CD20 monoclonal antibody (Mab) rituximab displays significant activity, and, while causing prolonged normal B-cell depletion, spares T-cells. Recombinant immunotoxins, containing an Fv fragment of a Mab fused to truncated Pseudomonas exotoxin, have shown efficacy in HCL resistant to both purine analogs and rituximab. LMB-2 targets CD25 and can induce remission providing the HCL cells are CD25+. All HCL cells display CD22. Recombinant anti-CD22 immunotoxin BL22, targeting CD22, has shown significant efficacy in phase I and II testing, and avoids prolonged suppression of both normal B- and T-cells. An improved high-affinity version of BL22, termed HA22, is currently undergoing phase I testing. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
| | PubMed ID | 19814696 |
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