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Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type with cladribine: a phase II study.

AbstractPURPOSE:
As chemotherapy has not been extensively studied in patients with lymphoma of the mucosa-associated lymphoid tissue (MALT), we initiated a prospective study to evaluate the activity of the nucleoside analog cladribine (2-chlorodeoxyadenosine [2-CdA]) in this disease.
PATIENTS AND METHODS:
Patients with histologically verified MALT-type lymphoma were enrolled. 2-CdA was administered at a dose of 0.12 mg/kg body weight on 5 consecutive days, as a 2-hour infusion. Cycles were repeated every 4 weeks for a maximum of six cycles.
RESULTS:
Nineteen patients with gastric and seven patients with extragastric MALT lymphoma were enrolled. All patients were chemotherapy-naive, and two had been locally irradiated before systemic relapse of the lymphoma. A total of 102 cycles was administered to our patients (median number of cycles per patient, four). All 25 assessable patients responded to treatment: 21 patients (84%) achieved complete remission (CR) and four patients achieved partial remission. All patients (100%) with gastric presentation, but only three patients (43%) with extragastric presentation, achieved CR. Toxicities were moderate and mainly hematologic and required dose reduction and/or premature discontinuation of therapy in only three cases. Two patients died from vascular events, one shortly after the first cycle because of myocardial infarction and the other from stroke 3 months after the second course. Three patients relapsed after 13, 18, and 22 months and one patient showed progressive disease after 15 months. At present, 24 patients are alive at a median follow-up time of 32 months.
CONCLUSION:
Our data demonstrate that 2-CdA is highly effective in inducing CR in 84% of patients with MALT-type lymphoma.
AuthorsGerald Jäger, Peter Neumeister, Ruth Brezinschek, Thomas Hinterleitner, Wolfgang Fiebiger, Melitta Penz, Hans J Neumann, Brigitte Mlineritsch, Maria DeSantis, Franz Quehenberger, Andreas Chott, Christine Beham-Schmid, Gerald Höfler, Werner Linkesch, Markus Raderer
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 20 Issue 18 Pg. 3872-7 (Sep 15 2002) ISSN: 0732-183X [Print] United States
PMID12228207 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article)
Chemical References
  • Antineoplastic Agents
  • Cladribine
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents (adverse effects, therapeutic use)
  • B-Lymphocytes
  • Cladribine (adverse effects, therapeutic use)
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Lacrimal Apparatus (pathology)
  • Liver (pathology)
  • Lymphoid Tissue (drug effects, pathology)
  • Lymphoma, B-Cell, Marginal Zone (drug therapy, pathology)
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Parotid Gland (pathology)
  • Prospective Studies
  • Remission Induction
  • Stomach Neoplasms (drug therapy, pathology)
  • Survival Rate

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