2-Chlorodeoxyadenosine with or without daunorubicin in relapsed or refractory acute myeloid leukemia.
(1998) Annals of hematology — Vol. 76, n° 1, p. 19-23 (1998)
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- 2-Chlorodeoxyadenosine (2-CdA) is a purine analogue which has proved to be active in acute myeloid leukemia (AML), especially in children. In adults, results yielded by 2-CdA alone or with ara-C were less encouraging. Here we report on the efficacy of 2-CdA with or without daunorubicin (DNR) in 19 relapsing or refractory adult AML patients, with a median age of 57 years. 2-CdA was administered as a continuous infusion to all patients at a dose of 0.1 mg/kg per day for 7 days. For 14 patients, DNR was added at a dose of 50 mg/m2 per day on days 5, 6, and 7. Antileukemic activity was observed in all the patients, but no single complete remission was achieved. One patient had a long-lasting partial response (response rate=5%). The remaining patients died of progressive AML (n=7), uncontrollable infection with persistent disease (n=10), and cerebral hemorrhage (n=1). Median survival from start of 2-CdA therapy was 56 days. Long-lasting neutropenia and transfusion-dependent thrombopenia were encountered in all 16 evaluable patients. Grade 4 hepatic toxicity occurred in one patient. Other side effects included nausea in six, mucositis in three, and mental disturbances in three patients. Compared with 2-CdA alone, the addition of DNR to 2-CdA changed neither the response rate nor the toxicities. In conclusion, our data do not support the use of 2-CdA +/- DNR for relapsing or refractory adult AML patients, at least as used in the present regimen.
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Van Den Neste, E., Martiat, P., Mineur, P., Delannoy, A., Doyen, C., Zenebergh, A., Michaux, J.-L., & Ferrant, A. (1998). 2-Chlorodeoxyadenosine with or without daunorubicin in relapsed or refractory acute myeloid leukemia. Annals of hematology, 76(1), 19-23. https://doi.org/10.1007/s002770050355 (Original work published 1998)