Long-term analysis of the palliative benefit of 2-chlorodeoxyadenosine for myelofibrosis with myeloid metaplasia.

Abstract

OBJECTIVE:

Therapeutic splenectomy in myelofibrosis with myeloid metaplasia (MMM) may result in extreme thrombocytosis and leukocytosis and accelerated hepatomegaly. We previously described initial palliative benefit from 2-chlorodeoxyadenosine (2-CdA) in such instances. The purpose of this study is to provide long-term follow-up on the durability of response in the initial cohort and in additional subsequent cases.

METHODS:

We retrospectively identified patients with histologically confirmed MMM who had palliative therapy with 2-CdA. Clinical characteristics and information on subsequent clinical course were abstracted at the time of diagnosis of MMM and at initiation of 2-CdA therapy until death.

RESULTS:

To date, we have used 2-CdA as palliative therapy in 14 patients with MMM. After a median of four cycles of therapy, responses for hepatomegaly occurred in 56% of patients, thrombocytosis 50%, leukocytosis 55%, and anemia 40%. Cytopenias were frequent but usually transient and without clinical consequence. Responses occurred usually by the second cycle; median duration of response was 6 months (range, 2-19) after completion of 2-CdA therapy.

CONCLUSION:

This study confirmed relevant and frequently durable palliation of symptoms in about half the patients. 2-CdA is a reasonable palliative option in postsplenectomy patients with MMM who have problematic myeloproliferation.

• Authors: Leonardo N Faoro, Ayalew Tefferi, Ruben A Mesa
• Journal: European journal of haematology (Eur J Haematol) Vol. 74 Issue 2 Pg. 117-20 (Feb 2005) ISSN: 0902-4441 [Print] England
• PMID: 15654901 (Publication Type: Journal Article)
• Copyright: (c) Blackwell Munksgaard 2005

Chemical References

• Antineoplastic Agents
• Cladribine

Topics

• Adult
• Aged
• Antineoplastic Agents (administration & dosage, adverse effects)
• Cladribine (administration & dosage, adverse effects)
• Female
• Follow-Up Studies
• Hematologic Diseases (chemically induced)
• Hepatomegaly (chemically induced)
• Humans
• Male
• Middle Aged
• Palliative Care
• Primary Myelofibrosis (complications, drug therapy, pathology, surgery)
• Retrospective Studies
• Splenectomy