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Prolonged follow‐up after initial therapy with 2‐chlorodeoxyadenosine in patients with indolent non‐Hodgkin lymphoma
Author(s) -
Blum Kristie A.,
Johnson Jeffrey L.,
Niedzwiecki Donna,
Piro Lawrence D.,
Saven Alan,
Peterson Bruce A.,
Byrd John C.,
Cheson Bruce D.
Publication year - 2006
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/cncr.22344
Subject(s) - medicine , gastroenterology , population , lymphoma , confidence interval , surgery , cancer , environmental health
BACKGROUND. The objective of this study was to determine the efficacy and toxicity of 2‐chlorodeoxyadenosine (2‐CdA) in patients with untreated, indolent non‐Hodgkin lymphoma (NHL). METHODS. For this multicenter, single‐arm, Phase II study, 44 patients with treatment‐naive, stage III or IV, indolent NHL (International Working Formulation subtypes A, B, and C) were enrolled. Patients received 0.14 mg/kg per day of 2‐CdA as a 2‐hour bolus infusion for 5 consecutive days every 28 days until maximal response or a total of 6 cycles. RESULTS. Thirty‐eight patients were eligible for response evaluation. The overall response rate was 100% (95% confidence interval [95% CI], 90.8–100%), and the complete response rate was 31.6% (95% CI, 17.5–48.7%). In the intent‐to‐treat population, the median failure‐free survival was 2.0 years (95% CI, 1.3–3.4 years), and the overall survival rate was 7.0 years (95% CI, 4.3–9.4 years). Six patients had sustained remissions that lasted a median of 8.7 years (range, from 5.9 years to ≥11 years). Although 68% of patients experienced at least 1 grade 3 or 4 event, consisting primarily of myelosuppression, severe infections were rare, with only 8 grade 3 infections. Four late malignancies (prostate adenocarcinoma, ductal carcinoma in situ, and myelodysplasia) and 4 patients with large cell transformation were reported. CONCLUSIONS. 2‐CdA is an active, well‐tolerated therapy for patients with untreated, indolent NHL. Cancer 2006. © 2006 American Cancer Society.