Phase I study of combined 2-chlorodeoxyadenosine and chlorambucil in chronic lymphoid leukemia and low-grade lymphoma.

Tefferi, Ayalew; Witzig, Thomas E.; Reid, Joel M.; Li, Chin Yang; Ames, Matthew M.

doi:10.1200/jco.1994.12.3.569

Cited by 36 publications

(18 citation statements)

References 29 publications

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“…In contrast to other studies using cladribine in association with either chlorambucil or mitoxantrone (Tefferi et al, 1994;Saven et al, 1996), the infection rate of our CCP combination was acceptable. This may indeed be attributable to selection bias as over 50% of the patients were previously untreated and could have better tolerated the treatment.…”

Section: Discussioncontrasting

confidence: 46%

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Cladribine with cyclophosphamide and prednisone in the management of low-grade lymphoproliferative malignancies

et al. 1999

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The feasibility of combining cladribine with cyclophosphamide and prednisone in the management of indolent lymphoid malignancies was determined. Nineteen patients [nine chronic lymphocytic leukaemia (CLL), seven non-Hodgkin's lymphoma (NHL) and three macroglobulinaemia (M))] received cladribine 0.1 mg kg −1 per day as a subcutaneous bolus injection on days 1–3 (up to 5 injections) with intravenous cyclophosphamide 500 mg m −2 on day 1 and oral prednisone 40 mg m −2 on days 1–5 at 4-weekly intervals up to a maximum of six courses. A total of 80 courses were given. Overall response rate was 88%, with four patients achieving a complete clinical and haematological response and 12 achieving a partial response. Neutropenia WHO grade 4 in two patients and WHO grade 3 infection in one patient were the limiting toxicities on treatment. During the follow-up, WHO grade ≥3 haematological complications occurred in five patients and WHO grade ≥3 non-haematological complications in five patients. There were no treatment-related deaths. This study demonstrates the feasibility of the cladribine/cyclophosphamide/prednisone (CCP) combination that appears highly active and safe in the management of indolent lymphoid malignancies. © 1999 Cancer Research Campaign

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Section: Discussioncontrasting

confidence: 46%

“…The same range of complications has been shown with cladribine given in combination with either chlorambucil or mitoxantrone to patients with indolent lymphoid malignancies (Tefferi et al, 1994;Saven et al, 1996). Early enthusiasm for the association of cladribine with other active cytotoxic agents may thus have been hampered by such adverse experiences.…”

mentioning

confidence: 87%

Cladribine with cyclophosphamide and prednisone in the management of low-grade lymphoproliferative malignancies

et al. 1999

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“…Several Phase I and II trials have piloted combinations of 2-CdA with mitoxantrone, [40][41][42] cyclophosphamide, 43,44 and chlorambucil. 45 However, in those initial trials, response rates from 28.5% to 90% (CR rate, 7.1-44%) appear similar to single-agent trials, and toxicities may be increased.…”

Section: Discussionmentioning

confidence: 99%

Prolonged follow‐up after initial therapy with 2‐chlorodeoxyadenosine in patients with indolent non‐Hodgkin lymphoma

Blum¹,

Johnson²,

Niedzwiecki³

et al. 2006

Cancer

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A H2O/dimethyl sulfoxide(DMSO) mixture was used as the coagulation bath for the wet‐spun process of acrylonitrile/ammonium itaconate copolymers fibers. Diffusion coefficient of DMSO in the protofibers prepared by acrylonitrile/ammonium itaconate copolymers was determined. It has been found that diffusion coefficient of DMSO outflow of the protofibers prepared by acrylonitrile/ammonium itaconate copolymers synthesized by the solution polymerization is highest compared with those of acrylonitrile/ammonium itaconate copolymers synthesized by H2O/DMSO mixture suspension polymerization and the aqueous suspension polymerization. With an increase of copolymer concentration in the dope, diffusion coefficient of DMSO decreases continuously. Diffusion coefficient of DMSO increases along with the bath temperature, but the changes of diffusion coefficient values are less prominent as temperature goes beyond 60°C. When DMSO concentration in the coagulation bath was 55 wt %, the value of the diffusion coefficient of DMSO was minimal. Diffusion coefficient of H2O increases with the jet stretch minus ratio increasing. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 100: 4447–4451, 2006

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“…59 The authors have shown that sequential therapy in previously untreated CLL patients is safe and can improve the quality of response in a large patient population compared to the therapy with FAMP alone. A similar study has been recently performed by Tefferi et al 88 They started the treatment with six cycles of intravenous CY (1 g/m 2 ) plus prednisone (100 mg/m 2 /day for 5 days) followed by 2 to 6 cycles of 2-CdA (5 mg/m 2 /day for 5 days). The OR and CR rates were 90% and 33%, respectively.…”

Section: Nucleoside Analogues Combined With Alkylatorsmentioning

confidence: 99%

“…A synergistic antitumour effect of chlorambucil was seen in CLL cells in vitro with DCF and 2-CdA. 88,89 The early clinical trials investigating the combination of chlorambucil with 2-CdA or FAMP in heavily pre-treated as well as previously untreated patients with CLL provided evidence that marrow suppression and infections were dose-limiting factors and that the doses of NA had to be lower in combination than in monotherapy. 89,90 …”

Section: Leukemiamentioning

confidence: 99%

Alkylating agents and nucleoside analogues in the treatment of B cell chronic lymphocytic leukemia

Robak

Kasznicki

2002

Leukemia

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Phase I study of combined 2-chlorodeoxyadenosine and chlorambucil in chronic lymphoid leukemia and low-grade lymphoma.

Abstract: These observations suggest the possibility of combining two cycles of continuous intravenously administered 2-CdA (2 mg/m2/d for 7 days) with standard doses of oral chlorambucil to test the efficacy of the combination regimen in phase II trials.

Cited by 36 publications

References 29 publications

Cladribine with cyclophosphamide and prednisone in the management of low-grade lymphoproliferative malignancies

Cladribine with cyclophosphamide and prednisone in the management of low-grade lymphoproliferative malignancies

Prolonged follow‐up after initial therapy with 2‐chlorodeoxyadenosine in patients with indolent non‐Hodgkin lymphoma

Alkylating agents and nucleoside analogues in the treatment of B cell chronic lymphocytic leukemia

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