Pentostatin, an adenosine deaminase inhibitor, has been approved for t
he treatment of refractory hairy cell leukemia. In a preclinical toxic
ity study, Wistar rats were administered 0, 1, 10, 25, and 50 mg/kg (0
, 6, 60, 150, and 300 mg/m(2), respectively) pentostatin intravenously
once a week for 26 wk (1.5-75-fold above the therapeutic dose in huma
ns). Lymphoplasmacytic thyroiditis was present in 20% of females given
25 mg/kg and in 20 and 47% of males and females given 50 mg/kg, respe
ctively. Thyroiditis was still present 4 wk following drug withdrawal.
Thyroiditis was characterized by glandular enlargement, follicular ep
ithelial hyperplasia and degeneration, colloid depletion, and intersti
tial infiltrates of lymphocytes and plasma cells. Drug-related changes
in other tissues included lymphoid depletion of T-cell regions of thy
mus, spleen, and lymph nodes; bronchiolization of alveolar ducts with
accumulation of mucus and foamy macrophages; testicular atrophy with s
perm granulomas; dermoepidermal lymphocytic infiltrates with ulceratio
n and alopecia; and hepatocytomegaly.