title: High response rates with short infusional 2-chlorodeoxyadenosine in de novo and relapsed low-grade lymphoma. Australian and New Zealand Lymphoma Study Group.
abstract: Thirty-five patients (eight de novo, 27 relapsed disease) with low-grade non-Hodgkin's lymphoma (diffuse small lymphocytic, follicular small cleaved cell, follicular mixed cell, and lymphoplasmacytoid) were treated with 2-chlorodeoxyadenosine (2CdA) at a daily dose of 0.14 mg/kg for 5d (2 h infusion) for an average of three cycles. Minor treatment delays, generally due to haematological toxicities, occurred in nine of 105 cycles. Major toxicities were lymphopenia, neutropenia and thrombocytopenia. Opportunistic infections occurred in seven patients. Overall response rate was 69% (five complete, 19 partial) reaching 88% for de novo patients (two complete, five partial). Elevated beta 2-microglobulin level was negatively predictive of response (P = 0.0014). Eight of 24 responders relapsed, with a median follow-up of 13 months. 2CdA administered as an intermittent infusion shows considerable single-agent activity in low-grade lymphomas achieving high response rates of prolonged duration. Consideration of schedules where 2CdA is alternatively administered with combination chemotherapy appears warranted.
authors.affiliation: Mater Misericordiae Hospitals, South Brisbane, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Morton
authors.forename: K
authors.initials: K
authors.lastname: Taylor
authors.forename: I
authors.initials: I
authors.lastname: Bunce
authors.forename: P
authors.initials: P
authors.lastname: Eliadis
authors.forename: A
authors.initials: A
authors.lastname: Rentoul
authors.forename: D
authors.initials: D
authors.lastname: Moore
authors.forename: C
authors.initials: C
authors.lastname: Kelly
authors.forename: S
authors.initials: S
authors.lastname: Wright
authors.forename: J
authors.initials: J
authors.lastname: Bashford
authors.forename: R
authors.initials: R
authors.lastname: Rodwell
authors.forename: K
authors.initials: K
authors.lastname: Rooney
authors.forename: S
authors.initials: S
authors.lastname: Mulligan
authors.forename: F
authors.initials: F
authors.lastname: Firkin
authors.forename: A
authors.initials: A
authors.lastname: Dodds
authors.forename: J
authors.initials: J
authors.lastname: Parkin
authors.forename: R
authors.initials: R
authors.lastname: Lowenthal
authors.forename: R
authors.initials: R
authors.lastname: Kimber
authors.forename: T
authors.initials: T
authors.lastname: Frost
authors.forename: A
authors.initials: A
authors.lastname: Grigg
authors.forename: D
authors.initials: D
authors.lastname: Goldstein
authors.forename: J
authors.initials: J
authors.lastname: Stone
authors.forename: N
authors.initials: N
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017338:Cladribine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D007970:Leukopenia / Q000139:chemically induced; D008224:Lymphoma, Follicular / Q000188:drug therapy*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000139:chemically induced; D012008:Recurrence; D016019:Survival Analysis; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D017338:Cladribine