Clinical overview of pentostatin (Nipent) use in lymphoid malignancies.
We summarize the results of our experience over the past 15 years using pentostatin (Nipent; SuperGen, San Ramon, CA) to treat a range of mature B- and T-cell malignancies. This includes 145 patients with postthymic T-cell malignancies in whom disease subtype was found to be the most significant predictor of response, with the best response rates seen in Sézary syndrome (62%) and T-prolymphocytic leukemia (45%). However, there are no long-term survivors among patients with this group of disorders, and strategies using pentostatin in combination with other therapies, such as CAMPATH-1H, are currently being explored. Among the mature B-cell diseases, pentostatin in both standard- and low-dose regimens is effective in advanced, relapsed/refractory B-chronic lymphocytic leukaemia, showing no cross-resistance with other purine analogs such as fludarabine. Our largest series treated with pentostatin consists of 165 patients with hairy cell leukemia. The follow-up period in this group extends to more than 10 years, with a projected event-free survival rate at 5 years of 60% and an overall survival rate of 97%.
Dearden
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Academic Department of Haematology and Cytogenetics, The Royal Marsden Hospital, London, UK.
Matutes
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Catovsky
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D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007938:Leukemia / Q000188:drug therapy*; D015448:Leukemia, B-Cell / Q000188:drug therapy; D007943:Leukemia, Hairy Cell / Q000188:drug therapy; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy; D015463:Leukemia, Prolymphocytic / Q000188:drug therapy; D015458:Leukemia, T-Cell / Q000188:drug therapy; D008223:Lymphoma / Q000188:drug therapy*; D016393:Lymphoma, B-Cell / Q000188:drug therapy; D016399:Lymphoma, T-Cell / Q000188:drug therapy; D015649:Pentostatin / Q000008:administration & dosage / Q000627:therapeutic use*; D012751:Sezary Syndrome / Q000188:drug therapy; D015996:Survival Rate; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use
D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D015649:Pentostatin; D014740:Vidarabine; C024352:fludarabine