CHLORODEOXYADENOSINE THERAPY OF PATIENTS WITH WALDENSTROM MACROGLOBULINEMIA PREVIOUSLY TREATED WITH FLUDARABINE

Background: Fludarabine monophosphate and 2Chlorodeoxyadenosine are nu cleoside analogues with activity against Waldenstrom macroglobulinemia . However, it is not clear whether prior exposure to one analogue prec ludes response to the other compound. Patients and methods: Fourteen p atients with Waldenstrom's macroglobulinemia and prior exposure to flu darabine were treated with two courses of 2chlorodeoxyadenosine. Resul ts: Three out of four patients that had previously responded to fludar abine and were relapsing from unmaintained remission, achieved a parti al response with 2chlorodeoxyadenosine therapy. However, only one out of 10 patients with disease resistant to fludarabine responded to 2chl orodeoxyadenosine. Conclusions: 2chlorodeoxyadenosine may be effective in patients with Waldenstrom macroglobulinemia sensitive to fludarabi ne. However, this compound has limited activity for patients with dise ase resistant to fludarabine.