Consensus Opinion from an International Group of Experts on Measurable Residual Disease in Hairy Cell Leukemia

A significant body of literature has been generated related to the detection of measurable residual disease (MRD) at the time of achieving complete remission (CR) in patients with hairy cell leukemia (HCL). However, due to the indolent nature of the disease as well as reports suggesting long-term survival in patients treated with a single course of a nucleoside analog albeit without evidence of cure, the merits of detection of MRD and attempts to eradicate it have been debated. Studies utilizing novel strategies in the relapse setting have demonstrated the utility of achieving CR with undetectable MRD (uMRD) in prolonging the duration of remission. Several assays including immunohistochemical analysis of bone marrow specimens, multi-parameter flow cytometry and molecular assays to detect the mutant BRAF V600E gene or the consensus primer for the immunoglobulin heavy chain gene (IGH) rearrangement have been utilized with few comparative studies. Here we provide a consensus report on the available data, the potential merits of MRD assessment in the front-line and relapse settings and recommendations on future role of MRD assessment in HCL.

Citing Articles

Recommendations for the Management of Patients with Hairy-Cell Leukemia and Hairy-Cell Leukemia-like Disorders: A Work by French-Speaking Experts and French Innovative Leukemia Organization (FILO) Group.

Paillassa J, Maitre E, Belarbi Boudjerra N, Madani A, Benlakhal R, Matthes T Cancers (Basel). 2024; 16(12).

PMID: 38927891 PMC: 11201647. DOI: 10.3390/cancers16122185.

SWIGH-SCORE: A translational light-weight approach in computational detection of rearranged immunoglobulin heavy chain to be used in monoclonal lymphoproliferative disorders.

Hansen M, Maagaard M, Cedile O, Nyvold C MethodsX. 2024; 12:102741.

PMID: 38846434 PMC: 11154698. DOI: 10.1016/j.mex.2024.102741.

Long-term results of the sequential combination of cladribine and rituximab in Hairy cell leukemia.

Marvin-Peek J, Jen W, Kantarjian H, McCue D, Haddad F, Wierda W Leuk Lymphoma. 2024; 65(9):1325-1334.

PMID: 38749022 PMC: 11646483. DOI: 10.1080/10428194.2024.2349700.

A Case of Hairy Cell Leukemia Variant: Literature Analysis With Focus on Unmet Needs.

Upadhyay A, Kumar M, Prasad A, Shekhar S, Singh R Cureus. 2023; 15(10):e47085.

PMID: 38022018 PMC: 10651060. DOI: 10.7759/cureus.47085.

Hairy Cell Leukemia: Where Are We in 2023?.

Mendez-Hernandez A, Moturi K, Hanson V, Andritsos L Curr Oncol Rep. 2023; 25(8):833-840.

PMID: 37097545 PMC: 10126561. DOI: 10.1007/s11912-023-01419-z.

References

Bruggemann M, Kotrova M, Knecht H, Bartram J, Boudjogrha M, Bystry V . Standardized next-generation sequencing of immunoglobulin and T-cell receptor gene recombinations for MRD marker identification in acute lymphoblastic leukaemia; a EuroClonality-NGS validation study. Leukemia. 2019; 33(9):2241-2253. PMC: 6756028. DOI: 10.1038/s41375-019-0496-7. View

Heuser M, Freeman S, Ossenkoppele G, Buccisano F, Hourigan C, Ngai L . 2021 Update on MRD in acute myeloid leukemia: a consensus document from the European LeukemiaNet MRD Working Party. Blood. 2021; 138(26):2753-2767. PMC: 8718623. DOI: 10.1182/blood.2021013626. View

Grever M, Kopecky K, Foucar M, Head D, Bennett J, Hutchison R . Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia: an intergroup study. J Clin Oncol. 1995; 13(4):974-82. DOI: 10.1200/JCO.1995.13.4.974. View

Arons E, Zhou H, Sokolsky M, Gorelik D, Potocka K, Davies S . Expression of the muscle-associated gene MYF6 in hairy cell leukemia. PLoS One. 2020; 15(2):e0227586. PMC: 7010284. DOI: 10.1371/journal.pone.0227586. View

Hakimian D, Tallman M, Kiley C, Peterson L . Detection of minimal residual disease by immunostaining of bone marrow biopsies after 2-chlorodeoxyadenosine for hairy cell leukemia. Blood. 1993; 82(6):1798-802. View

Andritsos L, Grever M . Historical overview of hairy cell leukemia. Best Pract Res Clin Haematol. 2015; 28(4):166-74. DOI: 10.1016/j.beha.2015.10.018. View

Broccoli A, Terragna C, Nanni L, Martello M, Armuzzi S, Agostinelli C . Droplet digital polymerase chain reaction for the assessment of disease burden in hairy cell leukemia. Hematol Oncol. 2021; 40(1):57-62. PMC: 9291464. DOI: 10.1002/hon.2932. View

Tallman M, Hakimian D, Kopecky K, Wheaton S, Wollins E, Foucar K . Minimal residual disease in patients with hairy cell leukemia in complete remission treated with 2-chlorodeoxyadenosine or 2-deoxycoformycin and prediction of early relapse. Clin Cancer Res. 1999; 5(7):1665-70. View

Andrulis M, Penzel R, Weichert W, von Deimling A, Capper D . Application of a BRAF V600E mutation-specific antibody for the diagnosis of hairy cell leukemia. Am J Surg Pathol. 2012; 36(12):1796-800. DOI: 10.1097/PAS.0b013e3182549b50. View

10.

Kreitman R, Dearden C, Zinzani P, Delgado J, Robak T, le Coutre P . Moxetumomab pasudotox in heavily pre-treated patients with relapsed/refractory hairy cell leukemia (HCL): long-term follow-up from the pivotal trial. J Hematol Oncol. 2021; 14(1):35. PMC: 7905554. DOI: 10.1186/s13045-020-01004-y. View

11.

Tiacci E, Pettirossi V, Schiavoni G, Falini B . Genomics of Hairy Cell Leukemia. J Clin Oncol. 2017; 35(9):1002-1010. PMC: 5455681. DOI: 10.1200/JCO.2016.71.1556. View

12.

Wheaton S, Tallman M, Hakimian D, Peterson L . Minimal residual disease may predict bone marrow relapse in patients with hairy cell leukemia treated with 2-chlorodeoxyadenosine. Blood. 1996; 87(4):1556-60. View

13.

Dearden C, Else M, Catovsky D . Long-term results for pentostatin and cladribine treatment of hairy cell leukemia. Leuk Lymphoma. 2011; 52 Suppl 2:21-4. DOI: 10.3109/10428194.2011.565093. View

14.

Ravandi F, OBrien S, Jorgensen J, Pierce S, Faderl S, Ferrajoli A . Phase 2 study of cladribine followed by rituximab in patients with hairy cell leukemia. Blood. 2011; 118(14):3818-23. PMC: 4081440. DOI: 10.1182/blood-2011-04-351502. View

15.

Matutes E, Meeus P, McLennan K, Catovsky D . The significance of minimal residual disease in hairy cell leukaemia treated with deoxycoformycin: a long-term follow-up study. Br J Haematol. 1997; 98(2):375-83. DOI: 10.1046/j.1365-2141.1997.2273044.x. View

16.

Kreitman R, Dearden C, Zinzani P, Delgado J, Karlin L, Robak T . Moxetumomab pasudotox in relapsed/refractory hairy cell leukemia. Leukemia. 2018; 32(8):1768-1777. PMC: 6087717. DOI: 10.1038/s41375-018-0210-1. View

17.

Cervetti G, Galimberti S, Andreazzoli F, Fazzi R, Cecconi N, Caracciolo F . Rituximab as treatment for minimal residual disease in hairy cell leukaemia. Eur J Haematol. 2004; 73(6):412-7. DOI: 10.1111/j.1600-0609.2004.00325.x. View

18.

Etienne G, Guilhot J, Rea D, Rigal-Huguet F, Nicolini F, Charbonnier A . Long-Term Follow-Up of the French Stop Imatinib (STIM1) Study in Patients With Chronic Myeloid Leukemia. J Clin Oncol. 2017; 35(3):298-305. DOI: 10.1200/JCO.2016.68.2914. View

19.

Tallman M, Hakimian D, Variakojis D, Koslow D, Sisney G, Rademaker A . A single cycle of 2-chlorodeoxyadenosine results in complete remission in the majority of patients with hairy cell leukemia. Blood. 1992; 80(9):2203-9. View

20.

Arons E, Margulies I, Sorbara L, Raffeld M, Stetler-Stevenson M, Pastan I . Minimal residual disease in hairy cell leukemia patients assessed by clone-specific polymerase chain reaction. Clin Cancer Res. 2006; 12(9):2804-11. DOI: 10.1158/1078-0432.CCR-05-2315. View