2-Chlorodeoxyadenosine therapy for disseminated Langerhans cell histiocytosis.

Abstract

OBJECTIVE:

To evaluate the efficacy of 2-chlorodeoxyadenosine (2-CDA), a purine nucleoside analogue, in treating disseminated Langerhans cell histiocytosis (LCH).

PATIENTS AND METHODS:

We retrospectively reviewed the clinical records of 5 patients who were seen at our institution for histologically confirmed disseminated LCH, including 1 patient with central nervous system parenchymal involvement. These patients were treated consecutively with 2-CDA chemotherapy between December 1994 and January 2001. The patients ranged in age from 19 to 81 years, and the median pretreatment duration of disease was 23 months. Median follow-up after initiation of 2-CDA treatment was 33 months. 2-Chlorodeoxyadenosine was used as frontline therapy for 1 patient and as salvage therapy for the other patients. Patients generally received 0.7 mg/kg over 5 or 7 days; the median number of courses was 4.

RESULTS:

Complete responses were achieved in 3 patients, including the patient with central nervous system disease, which, to our knowledge, has not been described previously. Two other patients achieved partial responses. The overall response rate was 100%. Toxic effects consisted mainly of myelosuppression; 1 patient developed dermatomal herpes zoster infection.

CONCLUSION:

Our experience confirms the reported efficacy of 2-CDA in the treatment of LCH; however, the optimal timing and schedule of therapy remain to be determined.

• Authors: Animesh Pardanani, Robert L Phyliky, Chin-Yang Li, Ayalew Tefferi
• Journal: Mayo Clinic proceedings (Mayo Clin Proc) Vol. 78 Issue 3 Pg. 301-6 (Mar 2003) ISSN: 0025-6196 [Print] England
• PMID: 12630583 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunosuppressive Agents
• Cladribine

Topics

• Adult
• Aged
• Aged, 80 and over
• Bone Marrow (drug effects)
• Brain Diseases (drug therapy, etiology)
• Cladribine (therapeutic use)
• Female
• Herpes Zoster (chemically induced)
• Histiocytosis, Langerhans-Cell (complications, drug therapy)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Male
• Middle Aged
• Retrospective Studies