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2-Chlorodeoxyadenosine activity in patients with untreated, indolent
non-Hodgkin's lymphoma
A Saven, S Emanuele, M Kosty, J Koziol, D Ellison and L Piro
Division of Hematology and Oncology, Ida M. and Cecil H. Green Cancer
Center, Scripps Clinic and Research Foundation, La Jolla, CA 92037, USA.
Based on the encouraging results of the use of 2-chlorodeoxyadenosine
([2-CdA], cladribine) in patients with advanced, low-grade lymphomas
resistant to conventional therapy and the acceptable toxicity profile
encountered, we conducted a phase II trial of 2-CdA in patients with
untreated indolent lymphomas. Twenty-eight patients with untreated low-
grade lymphomas were given 2-CdA at 0.1 mg/kg/d as a 7-day continuous
infusion every 28 to 35 days. A total of 89 courses, median of three
courses per patient, of 2-CdA were administered. Seventeen men and 11 women
with a median age of 58 years were treated. Fifteen patients had diffuse
small lymphocytic (8 with plasmacytoid features), 10 had follicular small
cleaved-cell, and there were single patients with monocytoid B-cell, mantle
cell and mucosa-associated lymphoid tissue (MALT) lymphoma histologies. All
28 patients were evaluable for toxicity and 26 were evaluable for response.
Nine (35%) patients (4 with diffuse small lymphocytic, 3 with follicular
small cleaved-cell, 1 with mantle cell, and 1 with MALT lymphoma) achieved
a complete response, and 14 (54%) patients (8 with diffuse small
lymphocytic, 5 with follicular small cleaved-cell, and 1 with monocytoid
B-cell lymphoma) achieved a partial response, for an overall response rate
of 88%. The median response duration was 10 months (range, 3 to 44+).
Myelosuppression was the principal toxicity. Actuarial survival at 60
months from initial diagnosis was 60% (95% confidence interval, 35% to 82%)
and at 48 months from treatment onset was 62% (95% confidence interval, 39%
to 83%). These results establish the major activity of 2- CdA in patients
with untreated indolent lymphoma, especially those with the diffuse small
lymphocytic subtype.
Volume 86,
Issue 5,
pp. 1710-1716,
09/01/1995
Copyright © 1995 by The American Society of Hematology
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