Pentostatin therapy of T-cell lymphomas with cutaneous manifestations

Purpose: To determine the side effects of and response to pentostatin in pa tients with T-cell lymphomas with cutaneous manifestations. Patients and Methods: pentostatin was administered to 28 patients who had r elapsed cutaneous T-cell lymphoma or peripheral T-cell lymphoma with promin ent cutaneous disease. The starting dose was between 3.75 to 5.0 mg/m(2)/d intravenous for 3 days every 3 weeks. Results: Of the 24 patients assessable for response, 17 (71%) achieved a pa rtial remission (46%) or complete remission (25%). The patients had a media n number of three (range, one to 12) prior therapies. Of the 86 courses of pentostatin given, 39 were administered at doses of 5.0 mg/m(2)/d and 30 at doses of 3.75 mg/m(2)/d. Dose escalatian to 6.25 mg/m(2)/d was possible in only five courses, and toxicity necessitated dose reduction to 2.8 mg/m(2) /d in 12 courses. The most common side effects were granulocytopenia, nause a, and nonneutropenic fever. Most patients developed significant lowering o f CD4 counts. Herpes tester was seen within 1 year after pentostatin in fiv e patients (19%). Conclusion: Pentostatin is an active agent in heavily pretreated T-cell lym phomas with cutaneous manifestations. (C) 1999 by American Society of Clini cal Oncology.