2′ deoxycoformycin (pentostatin) for refractory non‐Hodgkin's lymphoma: A calgb phase II study

Abstract

Seventy-six eligible patients with relapsed or refractory non-Hodgkin's lymphoma (NHL) were treated with 2'-deoxycoformycin (pentostatin) at a dose of 4 mg/m2 intravenously weekly for three weeks and then every other week for a minimum of five total treatments. All patients had measurable disease, near normal hematologic, renal, and hepatic function, and a performance status of 0 or 1. Severe hematologic toxicity was observed in 13% of patients; severe renal or neurologic toxicity was observed in less than 5% of patients. There were no treatment-related deaths. Objective therapeutic responses were seen in 16% of patients (five complete response [CR] and seven partial response [PR]). However, in three of the patients achieving CR and one patient achieving PR, dexamethasone was employed as an anti-emetic, making the response of these patients to pentostatin difficult to evaluate. There were eight responses (3 CR) in patients with diffuse histologies and four responses (2 CR) in patients with nodular or mixed histologies. Three responses were in patients with a T-cell phenotype. Three of five patients with diffuse well-differentiated lymphoma (IWF A) responded. We conclude that 2' deoxycoformycin is only minimally active at this dose and schedule against refractory or relapsed NHL. The possibility that low grade B- and T-cell malignancies are more sensitive to 2' deoxycoformycin deserves further investigation.

Pentostatin (2′-Deoxycoformycin, dCF) in Patients with Low-Grade (B-T-Cell) and Intermediate- and High-Grade (T-Cell) Malignant Lymphomas: Phase II Study of the EORTC Early Clinical Trials Group

“…Responses were, however, not transient since the median duration was 8 months. The results obtained by us are similar to those reported by other authors [17][18][19][20], The drug showed some activity in cuta neous T-cell and in low-grade N H L.…”

“…The toxicity of dCF is acceptable at low-dose schedule (4 mg/m2/week x 3 weeks and then every 2 weeks); as confirmed both by our study and that of C A L G B [18], dCF at this dose might be used in combination with myelosuppressive drugs for the first-line treatment of select ed malignant lymphomas, especially C T C L . In refractory low-grade lymphomas, among the purine analogues, fludarabine and 3-chlorodeoxyadenosine [21][22][23][24] have shown a better therapeutic activity than dCF but with more bone marrow toxicity.…”

Chemotherapy and treatment algorithms for follicular lymphoma: a look at all options

“…P was combined with rituximab (R-P) with or without mitoxantrone (R-PM) in advancedstage indolent NHL patients. R-PM regimen appeared to be superior to R-P in terms of ORR (73 vs 84%), but equivalent in terms of response duration (10 months in both regimens) [87,88]. More intensive regimens including P (i.e., pentostatin, bleomycin, mitoxantrone and prednisone) conferred a longer median duration of remission (38 months) and OS (71% at 3 years) [76].…”

Purine Analogs for the Treatment of Low-Grade Lymphoproliferative Disorders

“…All responses were seen in the 16 patients with Sezary syndrome, with no responses observed in the mycosis fungoides group. In the nodal lymphomas, RRs appear to be inferior to the other nucleoside analogs [79,97,98] (Table 3). The Cancer and Leukemia Group B conducted a trial using pentostatin at a dose of 4 mg/m 2 weekly for three weeks and then every other week in 76 previously treated patients, 49 of whom had noncutaneous low-grade lymphomas [97].…”