Major activity of cladribine in patients with de novo B-cell prolymphocytic leukemia.

Abstract

PURPOSE:

De novo B-cell prolymphocytic leukemia (B-PLL) is a distinct clinicopathologic entity usually characterized by marked lymphocytosis, massive splenomegaly, an aggressive course, and refractoriness to therapy. Cladribine (2-chlorodeoxyadenosine [2-CdA]; Ortho Biotech, Raritan, NJ) is a newer purine analog with potent activity against indolent lymphoproliferative disorders.

PATIENTS AND METHODS:

We treated eight patients with cladribine 0.1 mg/kg/d for 7 days by continuous infusion or 0.14 mg/kg/d over 2 hours for 5 days, every 28 to 35 days, for a median of three courses (range, two to five). There were five men and three women, with a median age of 62 years and a median pretreatment duration of 6 months; four patients were previously untreated.

RESULTS:

All eight patients were assessable: five achieved a complete response with a median response duration of 14 months (range, 1+ to 55+), and three achieved a partial response with a median duration of 3 months (range, 1 to 3). Of four patients who achieved a complete response and in whom a peripheral-blood immunophenotypic analysis was performed, two had no circulating B-PLL cells and one had no residual disease on Southern blot analysis. Myelosuppression and infection were the major toxicities: three patients developed grade 3 or 4 myelosuppression, four had bacterial infections, and two had herpes zoster infections.

CONCLUSION:

In this small study of patients with de novo B-PLL, cladribine was an active agent that induced a high overall and complete response rate. These results require confirmation in larger numbers of B-PLL patients.

• Authors: A Saven, T Lee, M Schlutz, A Jacobs, D Ellison, R Longmire, L Piro
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 15 Issue 1 Pg. 37-43 (Jan 1997) ISSN: 0732-183X [Print] United States
• PMID: 8996122 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents
• Cladribine

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents (adverse effects, therapeutic use)
• Cladribine (adverse effects, therapeutic use)
• Drug Administration Schedule
• Female
• Humans
• Leukemia, Prolymphocytic (drug therapy, microbiology, pathology)
• Male
• Middle Aged
• Neoplasm Staging