PENTOSTATIN (2'-DEOXYCOFORMYCIN) IN THE TREATMENT OF CUTANEOUS T-CELLLYMPHOMA

Background: The treatment of patients with advanced or therapy-refract ory cutaneous T-cell lymphoma (CTCL) remains a challenge. Pentostatin is a potent inhibitor of adenosine deaminase and is selectively toxic to lymphocytes. In a small number of patients with CTCL, it previously has been shown to be effective.Objective: Our purpose was to evaluate the efficacy and safety of pentostatin in the treatment of patients w ith advanced and/or therapy-refractory CTCL. Methods: Eighteen patient s with stage I to IVb CTCL were treated with 4 to 5 mg/m(2) of intrave nous pentostatin every 1 to 4 weeks. Results: Two patients (11%) had c omplete responses of 4 months and 6 years, respectively. These patient s had stage III and Na CTCL and had previously received many different external or systemic treatments. Partial remission (50% to 99% cleari ng) lasting for 1.5 to 6 months occurred in five patients (28%) with s tage IIa (n = 3), stage IIb, and stage IVa CTCL. The-se patients had r eceived a median of three prior external or systemic treatments. No ma jor side effects were observed, and bone marrow suppression was mild. Conclusion: Single-agent pentostatin in intravenous doses of 4 to 5 mg /m(2) is an effective systemic treatment of CTCL (39% objective respon se rate) with little toxicity.