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[7] [8] While most patients remain disease-free 10 years after treatment with these purine analogs, no patient has been followed long enough to assess cure. [9] [10] Both nucleoside analogs cause profound suppression of CD4 counts, which may last for a year. With the use of cladribine, an increased risk of second malignancies is possible among patients with hairy cell leukemia (observed to expected drink recipe ratio of about 1.8 in several series after 6 years). [4] [11] Several series drink recipe using pentostatin did not report an increased risk of second malignancies. [7] [9] [12] For a few patients, drink recipe such as those with severe thrombocytopenia, splenectomy can be considered. [13] After splenectomy, 50% of patients will require no additional therapy, and long-term survivors are common.
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