Abstract |
Before the contemporary development of rationally designed antineoplastic therapies, cladribine was identified as a lymphocyte-specific agent. Its profound impact on the natural history of hairy cell leukemia, with responses approaching 100% and a median duration of response of nearly a decade after only a single 7-day course, is well known and revolutionized the treatment of hairy cell leukemia. However, cladribine's impressive activity in other lymphoproliferative disorders has been generally underappreciated. Multiple single-arm phase 2 trials have demonstrated cladribine's potency across the full spectrum of lymphoid malignancies. In a limited number of phase 3 trials and cross-study analyses, cladribine compared favorably with fludarabine, another purine nucleoside analog that is more commonly used in the treatment of indolent lymphoid malignancies. Cladribine has been noted to have particular activity among lymphoid disorders with few effective therapies, specifically, chronic lymphocytic leukemia, lymphoplasmacytic lymphoma, marginal zone lymphoma, and mantle cell lymphoma. Recently approved novel agents may act in synergy with cladribine for these conditions and should be incorporated into future clinical studies.
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Authors | Darren S Sigal, Heather J Miller, Ethan D Schram, Alan Saven |
Journal | Blood
(Blood)
Vol. 116
Issue 16
Pg. 2884-96
(Oct 21 2010)
ISSN: 1528-0020 [Electronic] United States |
PMID | 20634380
(Publication Type: Journal Article, Review)
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Chemical References |
- Antineoplastic Agents
- Cladribine
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Topics |
- Antineoplastic Agents
(pharmacokinetics, pharmacology, therapeutic use)
- Cladribine
(pharmacokinetics, pharmacology, therapeutic use)
- Hematologic Neoplasms
(drug therapy)
- Humans
- Leukemia, Hairy Cell
(drug therapy)
- Leukemia, Lymphocytic, Chronic, B-Cell
(drug therapy)
- Leukemia, Myeloid, Acute
(drug therapy)
- Lymphoma, Mantle-Cell
(drug therapy)
- Lymphoma, Non-Hodgkin
(drug therapy)
- Waldenstrom Macroglobulinemia
(drug therapy)
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