Second primary tumors and immune phenomena after fludarabine or 2-chloro-2'-deoxyadenosine treatment.
The purine nucleoside analogs fludarabine and 2-chloro-2'-deoxyadenosine display substantial activity in the treatment of various chronic lymphoproliferative disorders. Their major toxicities are primarily immunosuppression and myelosuppression. The profound influence of these drugs on the immune system has raised questions as to the emergence of secondary neoplasms or auto-immune disorders after their use. Based on a literature review and on personal observations, this article reviews the potential clinical importance of these concerns.
Van Den Neste
E
E
Department of Hematology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium. vandenneste@sang.ucl.ac.be
Delannoy
A
A
Feremans
W
W
Ferrant
A
A
Michaux
L
L
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D015551:Autoimmunity; D017338:Cladribine / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D009369:Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000209:etiology* / Q000276:immunology; D014740:Vidarabine / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000276:immunology / Q000627:therapeutic use
D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D017338:Cladribine; D014740:Vidarabine; C024352:fludarabine