Evaluation of Cladribine treatment in refractory celiac disease type II

To evaluate cladribine [2-chlorodeoxyadenosine (2-CdA)] therapy in refractory celiac disease (RCD) II. An open-label cohort-study of RCD II patients treated with 2-CdA was performed between 2000 and 2010. Survival rate, enteropathy associated T-cell lymphoma (EATL) occurrence, clinical course, and h...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2011-01, Vol.17 (4), p.506-513
Main Authors: Tack, Greetje J, Verbeek, Wieke H M, Al-Toma, Abdul, Kuik, Dirk J, Schreurs, Marco W J, Visser, Otto, Mulder, Chris J J
Format: Article
Language:English
Subjects:
Adult
Aged
Brief
Celiac Disease - drug therapy
Celiac Disease - pathology
Celiac Disease - physiopathology
Cladribine - therapeutic use
Cohort Studies
Disease Progression
Female
Humans
Immunosuppressive Agents - therapeutic use
Kaplan-Meier Estimate
Male
Middle Aged
Remission Induction
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Summary:To evaluate cladribine [2-chlorodeoxyadenosine (2-CdA)] therapy in refractory celiac disease (RCD) II. An open-label cohort-study of RCD II patients treated with 2-CdA was performed between 2000 and 2010. Survival rate, enteropathy associated T-cell lymphoma (EATL) occurrence, clinical course, and histological and immunological response rates were evaluated. Overall, 32 patients were included with a median follow-up of 31 mo. Eighteen patients responded well to 2-CdA. Patients responsive to 2-CdA had a statistically significant increased survival compared to those who were unresponsive. The overall 3- and 5-year survival was 83% in the responder and 63% and 22% in the non-responder group, respectively. The overall 2-year clinical, histological and immunological response rates were 81%, 47% and 41%, respectively. Progression into EATL was reported in 16%, all of these patients died. Treatment of RCD II with 2-CdA holds promise, showing excellent clinical and histological response rates, and probably less frequent transition into EATL.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v17.i4.506