title: Treatment of refractory T-cell chronic lymphocytic leukemia with purine nucleoside analogues.
abstract: This report describes two cases of T-cell chronic lymphocytic leukemia (T-CLL) treated with purine nucleoside analogues. One patient had CD8+, CD3+ large granular lymphocytosis (LGL) producing transfusion-dependent anemia and was refractory to chemotherapy. Treatment with four cycles of fludarabine produced a clinical complete remission and a molecular genetic partial remission that has been durable for > 15 months. The other patient had CD4+ T-prolymphocytic leukemia and was unresponsive to both fludarabine and 2-chlorodeoxyadenosine. Further trials of these agents are warranted in T-CLL, especially the LGL variant.
authors.affiliation: Division of Internal Medicine and Hematology, Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: T E
authors.initials: TE
authors.lastname: Witzig
authors.forename: J J
authors.initials: JJ
authors.lastname: Weitz
authors.forename: J H
authors.initials: JH
authors.lastname: Lundberg
authors.forename: A
authors.initials: A
authors.lastname: Tefferi
mesh_terms: D015762:2-Chloroadenosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000740:Anemia / Q000188:drug therapy / Q000209:etiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017252:CD3 Complex; D015496:CD4-Positive T-Lymphocytes; D018414:CD8-Positive T-Lymphocytes; D003520:Cyclophosphamide / Q000008:administration & dosage; D003839:Deoxyadenosines / Q000627:therapeutic use*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D015463:Leukemia, Prolymphocytic / Q000188:drug therapy* / Q000473:pathology; D015461:Leukemia, Prolymphocytic, T-Cell / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D014411:Neoplastic Stem Cells / Q000187:drug effects / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage; D016879:Salvage Therapy; D014740:Vidarabine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014750:Vincristine / Q000008:administration & dosage; D015215:Zidovudine / Q000008:administration & dosage
chemical_list: D017252:CD3 Complex; D003839:Deoxyadenosines; D015762:2-Chloroadenosine; D015215:Zidovudine; D014750:Vincristine; D003520:Cyclophosphamide; D014740:Vidarabine; C055994:2-chloro-3'-deoxyadenosine; C024352:fludarabine; D011241:Prednisone; D008727:Methotrexate