Treatment of refractory large granular lymphocytic leukemia with 2-chlorodeoxyadenosine.
A 50-year-old man with large granular lymphocytic leukemia (CD3+, CD8+) complicated by severe pancytopenia and life-threatening infections refractory to therapy with prednisone, methotrexate, cyclosporine, and G-CSF is described. Treatment with two cycles of 2-chlorodeoxyadenosine (2-CDA) at 0.1 mg/kg by continuous intravenous infusion for 7 days each cycle resulted in resolution of cytopenias and clearance of leukemic cells. T-cell receptor gene rearrangement, initially present, was not detectable after therapy with 2-CDA. The rapid and complete response to 2-CDA after unsuccessful attempts with prior therapy suggests that 2-CDA should be considered for initial treatment of this disorder.
Edelman
M J
MJ
VA Northern California Health Care System, Martinez 94553, USA.
O'Donnell
R T
RT
Meadows
I
I
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017338:Cladribine / Q000627:therapeutic use*; D015321:Gene Rearrangement; D006801:Humans; D007945:Leukemia, Lymphoid / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011948:Receptors, Antigen, T-Cell / Q000235:genetics
D000970:Antineoplastic Agents; D011948:Receptors, Antigen, T-Cell; D017338:Cladribine