The CancerWeb Report, What's New In Cancer: January, 1997
Hematologic Malignancy

• Cladribine, a promising new drug for prolymphocytic leukemia - B-cell prolymphocytic leukemia (B-PLL) differs from chronic lymphocytic leukemia in showing a poorer response to alkylating drugs such as cyclophosphamide and chlorambucil. An article in the January, 1997 issue of the Journal of Clinical Oncology by researchers at the Scripps Clinic in La Jolla, California, reported very promising results with cladribine, a purine antimetabolite drug, in B-PLL. Of 8 assessable patients, 5 had a complete response lasting a median of 14 months and 3 had a partial response for about 3 months. Bone marrow suppression and infections were the main side-effects of treatment. A larger study is warranted to see if these findings hold up. (Saven, J Clin Oncol 15:37, 1997)

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• The role of splenectomy in treating chronic lymphocytic leukemia - Although splenectomy, the removal of the enlarged spleen that develops with chronic lymphocytic leukemia (CLL), was first used nearly 130 years ago, and has continued to be done ever since in many patients, there have been no controlled studies to determine whether it is actually of value. CLL is a disease of long duration which frequently becomes unresponsive to most drugs and leads to a very high load of tumor cells. A study of the records of patients who had undergone splenectomy at the M.D. Anderson Cancer Center in Houston, undertaken in a case-control format, appeared in the January, 1997 issue of the Journal of Clinical Oncology. The procedure had low mortality (about 9%), complications were manageable, and it provided significant benefit in terms of increased hematocrit and white blood cell counts. It was especially valuable for those patients with low platelet levels (below 100 million per mL). In Stage IV patients, 2-year survival was 51% for the splenectomized versus 28% for those not undergoing the procedure. (Seymour, J Clin Oncol 15:52, 1997)