ABSTRACT
2'-Deoxycoformycin (DCF) is a fermentation product of Streptomyces antibioticus. This drug was developed as a potent inhibitor of adenosine deaminase (ADA). Early studies demonstrated that the administration of DCF was associated with lymphocyte depletion in experimental animals but that in vitro lymphocytotoxicity required the addition of deoxyadenosine. In the initial clinical studies of DCF conducted in Britain in the late 1970s, Smyth et al. showed that the degree of ADA inhibition depended on both dose and schedule of administration. DCF has been most widely studied in hairy cell leukemia and chronic lymphocytic leukemia, with less extensive evaluation in the indolent non-Hodgkin’s lymphomas and T-cell disorders. DCF has proven to be highly effective in the therapy of lymphoid malignancies, most notably hairy cell leukemia. However, it may be associated with a number of potentially severe toxicities, especially in patients with renal insufficiency and at higher doses than are recommended.
