title: The effect of 2-h infusion of 2-chlorodeoxyadenosine (cladribine) with prednisone in previously untreated B-cell chronic lymphocytic leukaemia.
abstract: 2-Chlorodeoxyadenosine (2-CdA) is a new antimetabolite chemotherapeutic agent active in indolent lymphoid malignancies. In this retrospective study, 69 previously untreated patients with B-cell chronic lymphocytic leukaemia (B-CLL) were treated with 2-CdA administered at a dose of 0.12 mg/kg daily in 2-h intravenous infusion for 5 consecutive days. 45 patients also received prednisone 30 mg/m2 orally each day for 5 days starting with 2-CdA courses. Patients were given 2-6 courses (mean 4.6) of 2-CdA repeated usually at monthly intervals. If a complete response was achieved, no further 2-CdA courses were administered. Guidelines for response were those developed by the NCI Sponsored Working Group. Complete response (CR) was achieved in 26 (38%) and partial response (PR) in 27 (39%) cases, giving an overall response rate of 77%. 16 patients (23%) did not respond to 2-CdA. In the subgroup of 45 patients receiving 2-CdA with prednisone, CR was obtained in 15 (33%) and PR in 20 (44%) patients giving an overall response rate of 78%. CR was achieved in 11 (46%) out of 24 patients treated only with 2-CdA and in 7 cases (29%) PR was observed, giving an objective response rate of 75%. The differences between both subgroups were not statistically significant. However, we observed a relationship between the response and the number of courses of 2-CdA given in patients receiving and those not receiving prednisone. In the subgroup receiving 2-CdA with prednisone, an earlier response to 2-CdA was observed. In this group a response was achieved in 9 (20%) patients after two courses of 2-CdA and in 18 (40%) after four courses. In the subgroup receiving only 2-CdA, 17 (71%) responses were obtained after six cycles.
authors.affiliation: Department of Haematology, Medical University of Lodz, Poland.
authors.forename: T
authors.initials: T
authors.lastname: Robak
authors.forename: M
authors.initials: M
authors.lastname: Błasińska-Morawiec
authors.forename: J Z
authors.initials: JZ
authors.lastname: Błoński
authors.forename: E
authors.initials: E
authors.lastname: Krykowski
authors.forename: M
authors.initials: M
authors.lastname: Komarnicki
authors.forename: E
authors.initials: E
authors.lastname: Trepińska
authors.forename: M
authors.initials: M
authors.lastname: Kaźmierczuk
authors.forename: J
authors.initials: J
authors.lastname: Hansz
authors.forename: A
authors.initials: A
authors.lastname: Dmoszyńska
authors.forename: J
authors.initials: J
authors.lastname: Roliński
authors.forename: L
authors.initials: L
authors.lastname: Konopka
authors.forename: A B
authors.initials: AB
authors.lastname: Skotnicki
authors.forename: W S
authors.initials: WS
authors.lastname: Nowak
authors.forename: S
authors.initials: S
authors.lastname: Kotlarek-Haus
authors.forename: B
authors.initials: B
authors.lastname: Zdziarska
authors.forename: I
authors.initials: I
authors.lastname: Urasiński
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017338:Cladribine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D017338:Cladribine; D011241:Prednisone