Premium
Complete hematologic remissions in chronic‐phase, philadelphia‐chromosome‐positive, chronic myelogenous leukemia after 2‐chlorodeoxyadenosine
Author(s) -
Saven Alan,
Piro Lawrence D.,
Lemon Robert H.,
Figueroa Michael L.,
Kosty Michael,
Ellison Douglas J.,
Beutler Ernest
Publication year - 1994
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19940615)73:12<2953::aid-cncr2820731212>3.0.co;2-v
Subject(s) - medicine , cladribine , chronic myelogenous leukemia , hairy cell leukemia , immunosuppression , gastroenterology , myeloid , myeloid leukemia , immunology , leukemia
Background. 2‐Chlorodeoxyadenosine (Cladribine, Leustatin, Ortho Biotech, Raritan, NJ) (2‐CdA) is a purine analog with activity in the treatment of lymphoid neoplasms. Interferon induces cytogenetic remissions in chronic myeloid leukemia (CML) and partial remissions in hairy cell leukemia, a disorder in which single courses of 2‐CdA induce complete remissions. In vitro clonal growth of immature myeloid progenitors from normal marrow is markedly inhibited by 2‐CdA. Methods. 2‐CdA was administered to 12 patients with Philadelphia‐chromosome‐positive CML, 11 chronic phase, and 1 accelerated phase, at 0.1 mg/kg/day by continuous intravenous infusion for 7 days every 28–35 days, until maximum peripheral hematologic response. Results. Of 12 patients, 10 (83%) achieved complete hematologic responses and 2 (17%) partial hematologic responses after a median of two courses of 2‐CdA. The median first hematologic response duration was 3 months. Of the seven patients who relapsed and were retreated with a median of two further courses of 2‐CdA, five obtained responses (four complete and one partial) and two did not respond. The median second hematologic response duration was 4 months. No patient had significant Philadelphia‐chromosome suppression. Reversible myelosuppression and severe cumulative T‐cell immunosuppression associated with opportunistic infections in four patients were the principal toxicities. Conclusions. 2‐CdA is active in CML, inducing complete hematologic responses, but the absence of cytogenetic responses and severe immunosuppression may limit its clinical use. Cancer 1994; 73:2953–63.