ABSTRACT
The introduction of the purine analogs, fludarabine monophosphate, 2-chlorodeoxyadenosine (2-CDA), and pentostatin into clinical practice has enlivened the area of chemotherapy of chronic lymphocytic leukemia (CLL). The drug most extensively studied in CLL is fludarabine monophosphate. A question that has arisen in the 2-CDA-treated patients is whether the patients who have failed fludarabine will respond to 2-CDA. No direct comparisons of the activity of 2-CDA and fludarabine in a randomized comparative trial have been conducted. Little information was available on the response to treatment in patients who relapsed and very few new agents were either investigated in the disease or demonstrated activity in clinical trials. The only clinical studies with sufficient maturity to gain an appreciation of the long-term follow-up of patients receiving Fludara in their initial therapy comes from the M. D. Anderson Cancer Center.
