PERSPECTIVES ON PURINE ANALOGS

The purine analogs, fludarabine, 2-chlorodeoxy-adenosine, and 2'-deoxy coformycin, have revolutionized our approach to the treatment of a var iety of indolent lymphoid malignancies. Because of their impressive si ngle agent activity, they should be considered as an initial therapeut ic option, not only for hairy cell leukemia, but also for chronic lymp hocytic leukemia, indolent non-Hodgkin's lymphomas, and Waldenstrom's macroglobulinemia. Combinations of purine analogs with alkylatng agent s, topisomerase II inhibitors, and other new compounds are in developm ent, and their role as radiation sensitizers is being explored in clin ical trials. Substantial activity has also been noted in several of th e rheumatologic and immunologic disorders, and in multiple sclerosis. Continued progress requires innovative strategies which can modulate t he biology and immunology of these diseases toward the goal of curing these patients.