John Libbey Eurotext

Hématologie

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2-Chlorodesoxyadenosine in chronic blood malignancies Volume 1, issue 5, Septembre - Octobre 1995

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Service d'hématologie des cliniques universitaires Saint-Luc, avenue Hippocrate, 1200 Bruxelles, Belgique.

Together with fludarabine monophosphate and deoxycoformycin, 2-chlorodeoxyadenosine (CdA) belongs to the family of purine analogues. These drugs have proved most effective in the therapy of chronic lymphoid malignancies. A complete remission is obtained in most patients with hairy cell leukemia with one single course of CdA. However, residual disease is consistently demonstrated in the bone marrow of complete responders with the use of PCR technology. Thirty to 50% of patients with relapsing or refractory non-Hodgkin’s lymphoma will achieve some response to CdA. Waldenström’s macroglobulinemia may turn to be an excellent indication for CdA, not only because a response is archived in many patients (from 40% in previously treated patients to 70% in patients given CdA upfront) but mainly because responses are long-lived. The respective activity of CdA and of fludarabine in chronic lymphocytic leukemia are of the same order of magnitude. Short intravenous perfusions, sub-cutaneaous and oral administration (in the latter case, the dose of CdA should be doubled) are as effective as continuous intravenous infusions. Infection resulting from immunosuppression and from neutropenia induced by CdA is its most common side effect.