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World J Gastroenterol. 2011 Jan 28;17(4):506-13. doi: 10.3748/wjg.v17.i4.506.

Evaluation of Cladribine treatment in refractory celiac disease type II.

Author information

  • 1Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, The Netherlands. g.tack@vumc.nl

Abstract

AIM:

To evaluate cladribine [2-chlorodeoxyadenosine (2-CdA)] therapy in refractory celiac disease (RCD) II.

METHODS:

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.

RESULTS:

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.

CONCLUSION:

Treatment of RCD II with 2-CdA holds promise, showing excellent clinical and histological response rates, and probably less frequent transition into EATL.

KEYWORDS:

Cladribine; Clinical course; Enteropathy associated T-cell lymphoma; Refractory celiac disease; Survival

PMID:
21274381
[PubMed - indexed for MEDLINE]
PMCID:
PMC3027018
Free PMC Article
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