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World J Gastroenterol. 2011 January 28; 17(4): 506–513.
Published online 2011 January 28. doi:  10.3748/wjg.v17.i4.506
PMCID: PMC3027018

Evaluation of Cladribine treatment in refractory celiac disease type II

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

Articles from World Journal of Gastroenterology : WJG are provided here courtesy of Baishideng Publishing Group Inc