ABSTRACT
Pentostatin, fludarabine, and 2-chlorodeoxyadenosine (2-CdA) have been extensively used in clinical trials for patients with a variety of lymphoproliferative disorders. Information has accumulated on the use of these drugs in other lymphoproliferative malignancies, and in hematologic malignancies in general. The treatment of Waldenstrom’s macroglobulinemia has for a long time consisted of plasmapheresis to control the signs and symptoms of hyperviscosity that characterize this disease, as well as chemotherapy to control the proliferation of the malignant plasmacytoid lymphocytes. The responsiveness observed with nucleoside analogs in B-cell malignancies, prompted the use of these agents in patients with multiple myeloma. Prolymphocytic leukemia is a distinct clinicopathologic variant of chronic lymphocytic leukemia characterized by the presence of prolymphocytes in peripheral blood and bone marrow. The nucleoside analogs have in vitro activity against some acute leukemia cell lines. Although hematologic responses can be induced with 2-CdA, the lack of cytogenetic responses and the severe immunosuppression observed may discourage its future investigation in chronic myelogenous leukemia.
