2-chlorodeoxyadenosine (cladribine) in the treatment of elderly patients with B-cell chronic lymphocytic leukemia

The aim of our study was to determine the efficacy and toxicity of 2-chloro deoxyadenosine (2-CdA) in 2-hour infusions in the treatment of elderly pati ents with B-cell chronic lymphocytic leukemia (B-CLL). Forty three patients aged 70 years and older received 1 to 6 courses of 2-CdA (median 3) in a d ose of 0.12 mg/kg daily for 5 consecutive days. Thirty three of them were u ntreated and 10 had relapsed or refractory to disease after prior therapy w ith chlorambucil, COP and CHOP. Complete response (CR) was achieved in 13 ( 30.2%) and partial response (PR) in 17 (39.6%) patients, giving an overall response rate of 69.8%. The difference in overall response rate between bot h groups were not statistically significant (69.8% and 50%, respectively). The most frequent side effects of 2-CdA treatment were thrombocytopenia obs erved in 18 (41.9%) and infections in 7 (16.3%) patients. Drug related neut ropenia was observed in 6 (13.9%) and allergic dermatitis in 2 patients. Si x (13.9%) patients died, one because of drug related thrombocytopenia resul ting in a central nervous system hemorrhage, two because of pneumonia and t wo of cardiovascular complications. In conclusion, our results suggest that 2-CdA is also effective treatment for elderly patients with CLL. The drug toxicity is acceptable and seems to be similar for that observed in younger patients.