Pentostatin treatment combinations in chronic lymphocytic leukemia.
There have been great strides in the treatment of chronic lymphocytic leukemia (CLL). Fludarabine is the most widely studied of the purine analogs that have significantly impacted the treatment of this disease. Pentostatin has also been shown to have clinical activity in CLL and appears to be less toxic than its fludarabine counterpart, which may offer some important advantages. This text will review the rationale and more recent clinical trial results for pentostatin-based combinations in both the upfront and relapsed treatment setting for patients with CLL. Attention to the frequency of response, ability to achieve minimal residual disease, and toxicity from these approaches will be emphasized. Where feasible, we will also compare the impact of pentostatin-based treatments to fludarabine-based combinations in CLL. In addition, this review will update the latest relevant work presented at the recent 2008 American Society of Hematology meeting and future directions in regard to the continued study of pentostatin-based combinations will be discussed.
Lamanna
Nicole
N
Division of Hematology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Kay
Neil E
NE
D000367:Age Factors; D000368:Aged; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D000912:Antibodies, Neoplasm / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017322:Clinical Trials, Phase II as Topic / Q000706:statistics & numerical data; D003520:Cyclophosphamide / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005544:Forecasting; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D015337:Multicenter Studies as Topic; D015649:Pentostatin / Q000008:administration & dosage / Q000009:adverse effects; D000069283:Rituximab; D016879:Salvage Therapy; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D000912:Antibodies, Neoplasm; D015649:Pentostatin; D000074323:Alemtuzumab; D000069283:Rituximab; D003520:Cyclophosphamide; D008942:Mitoxantrone; D014740:Vidarabine; C024352:fludarabine