LONG-TERM FOLLOW-UP AND LATE COMPLICATIONS OF 2-CHLORODEOXYADENOSINE IN PREVIOUSLY TREATED, ADVANCED, INDOLENT NON-HODGKINS-LYMPHOMA

BACKGROUND. The aim of this study was to determine the long term outco me and toxicities after the administration of 2-chlorodeoxyadenosine ( 2-CdA) to patients with previously treated, advanced, indolent non-Hod gkin's lymphoma (NHL). METHODS, Twenty-two patients (median age, 55 ye ars) with relapsed or refractory low grade NHL (median disease duratio n, 2.8 years) were treated with 2-CdA by continuous infusion at 0.1 mg /kg/day over 5 or 7 days every 28 days, for a maximum of 6 cycles. RES ULTS, The overall response rate was 45%. Two patients (9%) achieved a complete response (CR), 8 patients (36%) achieved a partial response, and 12 patients (55%) had no response. The two patients achieving CR h ave remained in CR for 46 and 38 months, respectively. Freedom from tr eatment failure at 24 months was 32%. Overall survival at 24 months wa s 59%. Three patients developed second malignancies: acute myelogenous leukemia (AML), myelodysplastic syndrome, and a cutaneous lymphoproli ferative disorder. Fourteen patients have died after a median follow-u p of 28 months (range, 3.9-49.2 months) due to progressive NHL (11 pat ients), infection (2 patients), and AML (1 patient). CONCLUSIONS. 2-Cd A is an active agent for patients with previously treated, advanced, i ndolent NHL and may result in lasting remissions. Late complications f ollowing treatment may include delayed bacterial, fungal, or viral inf ection. Determination of whether the second malignancies that occurred in three patients reported herein were related to treatment with 2-Cd A will require further study. (C) 1998 American Cancer Society.