Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:12

654 Hairy Cell Leukemia Hantavirus Pulmonary Syndrome

■Agnogenic myeloid metaplasia

■Systemic mastocytosis

management

What to Do First

■To decide when to initiate treatment

Indications for Treatment

■Constitutional symptoms

■Symptomatic organomegaly

■Significant cytopenias (ANC <1,000/mm3, Hb <11 g/dl, Plt

<100,000/mm3)

specific therapy

■Cladribine (2-CdA): 0.1 mg/kg/day continuous iv

➣infusion×7 days×1 dose or

■Pentostatin 4 mg/m2 i.v. q 2 wks for 2–4 mths or

■Interferon 2 million U SQ TIW for 12–18 mths

Surgery

■Splenectomy

follow-up

n/a

complications and prognosis

Complications

■Pancytopenia

■Recurrent infection

Prognosis

■90% of the patients respond to 2-CdA

■4-year survival is about 85–95%

Hantavirus Pulmonary Syndrome........................

CAROL A. GLASER, MD

history & physical

History

■Bunyaviridae family

■Many hantaviruses worldwide; this section will cover only HPS,

which is clinically important hantavirus in the U.S.