Journal of Clinical Oncology, Vol 10, 371-377, Copyright © 1992 by American Society of Clinical Oncology
2-Chlorodeoxyadenosine treatment of low-grade lymphomas
AC Kay, A Saven, CJ Carrera, DA Carson, D Thurston, E Beutler and LD Piro
Division of Hematology and Oncology, Scripps Clinic and Research Foundation, La Jolla, CA 92037.
PURPOSE: Because of the need to identify effective new agents in the
treatment of non-Hodgkin's lymphoma and because of the high activity of the
purine analog 2-chlorodeoxyadenosine (2-CdA) against chronic lymphocytic
leukemia and hairy cell leukemia, a phase II trial of 2-CdA was initiated
in patients with low-grade lymphocytic lymphomas. PATIENTS AND METHODS:
Forty patients with low-grade lymphocytic lymphomas including diffuse small
lymphocytic, follicular small- cleaved, and follicular mixed histologies
were enrolled onto the study. Conventional therapies had failed in all
patients, and six patients had lymph node biopsies showing evidence of
histologic evolution to a higher-grade lymphoma. A total of 107 courses of
2-CdA were administered. There were 27 males and 13 females. The median age
was 59 years (range, 37 to 80 years). Patients had received a median of
three prior therapies (range, one to six therapies). RESULTS: An overall
response rate of 43% was achieved, with eight patients experiencing
complete responses (CRs) and nine patients experiencing partial responses
(PRs). The duration of responses ranged from 1 to greater than 33 months
without maintenance therapy (median duration of response, 5 months).
Histology and prior therapy history did not seem to correlate with
responses. Significant toxicity was limited to bone marrow suppression; 18%
of patients developed neutropenia, and 30% developed thrombocytopenia.
CONCLUSIONS: This phase II trial demonstrates that 2-CdA is an effective
antilymphocyte, antineoplastic agent with significant activity as a single
agent in patients with recurrent or refractory low-grade lymphocytic
lymphoma. Responses were achieved with an acceptable toxicity profile.
Further trials of this agent in previously untreated patients and in
combination regimens are indicated and will be developed.
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