2-CHLORODEOXYADENOSINE WITH OR WITHOUT DAUNORUBICIN IN RELAPSED OR REFRACTORY ACUTE MYELOID-LEUKEMIA

2-Chlorodeoxyadenosine (2-CdA) is a purine analogue which has proved t o be active in acute myeloid leukemia (AML), especially in children. I n adults, results yielded by 2-CdA alone or with ara-C were less encou raging. Here we report on the efficacy of 2-CdA with or without daunor ubicin (DNR) in 19 relapsing or refractory adult AML patients, with a median age of 57 years. 2-CdA was administered as a continuous infusio n to all patients at a dose of 0.1 mg/kg per day for 7 days. For 14 pa tients, DNR was added at a dose of 50 mg/m(2) per day on days 5, 6, an d 7. Antileukemic activity was observed in all the patients, but no si ngle complete remission was achieved. One patient had a longlasting pa rtial response (response rate=5%). The remaining patients died of prog ressive AML (n=7), uncontrollable infection with persistent disease (n =10), and cerebral hemorrhage (n=1). Median survival from start of 2-C dA therapy was 56 days. Long-lasting neutropenia and transfusion-depen dent thrombopenia were encountered in all 16 evaluable patients. Grade 4 hepatic toxicity occurred in one patient. Other side effects includ ed nausea in six, mucositis in three, and mental disturbances in three patients. Compared with 2-CdA alone, the addition of DNR to 2-CdA cha nged neither the response rate nor the toxicities. In conclusion, our data do not support the use of 2-CdA +/- DNR for relapsing or refracto ry adult AML patients, at least as used in the present regimen.