Purine Analogs, Including Fludarabine, in Second-Line Therapy for CLL

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Semin Hematol. 2006 Apr;43(2 Suppl 2):S44-9.

Purine analogue-based chemotherapy regimens for second-line therapy

in patients with chronic lymphocytic leukemia.

Lamanna N, Weiss MA.

Department of Medicine, Leukemia Service, Memorial Sloan-Kettering

Cancer Center, New York, NY.

A dramatic change has occurred in the management of chronic

lymphocytic leukemia (CLL) over the past 20 years. The use of newer

therapies, including the purine analogues, has resulted in higher

frequencies of response.

Combination therapy with purine analogues, alkylators, and/or

monoclonal antibodies represents a promising new approach to the

treatment of patients with CLL. The most commonly studied regimens

have utilized fludarabine, but severe myelosuppression and

immunosuppression of these combinations require close attention to

dosing and schedule. Of the purine analogues that show activity in

CLL, pentostatin appears to be the least myelosuppressive.

These combination strategies are associated with high-quality

responses in the majority of patients and may one day lead to

improved survival or possibly even a cure for patients with CLL.

PMID: 16549114 [PubMed - in process]