2-CHLORODEOXYADENOSINE TREATMENT IN NON-HODGKINS-LYMPHOMA AND B-CELL CHRONIC LYMPHOCYTIC-LEUKEMIA RESISTANT TO CONVENTIONAL CHEMOTHERAPY - RESULTS OF A MULTICENTRIC EXPERIENCE

Among the purine analogs, 2-chlorodeoxyadenosine (2-CDA) is particular ly effective for the treatment of hairy cell leukemia and Waldemstrom' s macroglobulinemia. Both efficacy and toxicity of 2-CDA were evaluate d in previously treated patients affected with chronic lymphoprolifera tive disorders such as low-grade non-Hodgkin's lymphoma (NHL) and B-ce ll chronic lymphocytic leukemia (CLL). Thirty cases: mainly refractory , 16 affected with CLL, were included from six centers of the Internat ional Society for Chemo-Immunotherapy (IGCI). 2-CDA was administered i n a 2 h i.v. infusion for 5-7 days at the standard dose of 0.1 mg/kg/d ay every 4 weeks. The median number of cycles was 3. Of 30 cases, eigh t (26.7%) achieved a complete remission (CR), nine (30%) a partial rem ission (PR), and two (6.7%) a minor response, while five cases (16.6%) did not respond, and six (20%) were considered early deaths. The over all response rate (CR+PR) was 56.7%, with a median response duration o f 12 months (range 3-28 +) and a better response in CLL patients. Cons idering that the majority of patients were heavily pretreated, toxicit y was acceptable, with 40% of cases not presenting any toxic effect. T he main toxicity consisted in infectious complications. Based on the r esults of the present study, we confirm that 2-CDA is an effective dru g in these lymphoproliferative disorders, suggesting its possible use either alone or in combination, also as first-line therapy.