HIGH RESPONSE RATES WITH SHORT INFUSIONAL 2-CHLORODEOXYADENOSINE IN DE-NOVO AND RELAPSED LOW-GRADE LYMPHOMA

Thirty-five patients (eight de novo, 27 relapsed disease) with low-gra de non-Hodgkin's lymphoma (diffuse small lymphocytic, follicular small cleaved cell, follicular mixed cell, and lymphoplasmacytoid) were tre ated with 2-chlorodeoxyadenosine (2CdA) at a daily dose of 0.14 mg/kg for 5 d (2 h infusion) for an average of three cycles. Minor treatment delays, generally due to haematological toxicities, occurred in nine of 105 cycles. Major toxicities were lymphopenia, neutropenia and thro mbocytopenia. Opportunistic infections occurred in seven patients. Ove rall response rate was 69%, (five complete. 19 partial) reaching 88%, for ne novo patients (two complete, five partial). Elevated beta(2)-mi croglobulin level was negatively predictive of response (P = 0.0014), Eight of 24 responders relapsed, with a median follow-up of 13 months. 2CdA administered as an intermittent. infusion shows considerable sin gle-agent activity in low-grade lymphomas achieving high response rate s of prolonged duration. Consideration of schedules where 2CdA is alte rnatively administered with combination chemotherapy appears warranted .