PENTOSTATIN (2'-DEOXYCOFORMYCIN, NIPENT(R)) - A STRUCTURAL ANALOG OF THE PURINE ADENOSINE ACTING AS POTENT ADENOSINE-DEAMINASE INHIBITOR

Pentostatin, a structural analogue of the purine adenosine, is acting as a potent inhibitor of adenosine deaminase. It has been studied in t he treatment of various lymphoproliferative disorders and proved to be very effective in the treatment of hairy-cell leukemia achieving comp lete remissions in up to 93%, complete or partial remissions in 63 to 100% of patients. Furthermore, pentostatin has shown activity in treat ing chronic lymphocytic leukemia, prolymphocytic leukemia, adult T cel l leukemia/lymphoma and especially cutaneous T cell lymphoma refractor y to conventional chemotherapy. Randomized clinical studies show that in the treatment of hairy-cell leukemia pentostatin achieves a faster response, significantly higher response rates and longer duration of r emissions than interferon-alpha. Nevertheless it remains uncertain if patients with complete remission have finally been cured. Since pentos tatin does produce a substantial response in a highly practicable ther apy with low toxicity it should be applied as standard first-line trea tment of hairy-cell leukemia.