Response to 2-chlorodeoxyadenosine in patients with B-cell chronic lymphocytic leukemia resistant to fludarabine.
Response to 2-chlorodeoxyadenosine in patients with B-cell chronic lymphocytic leukemia resistant to fludarabine.
复制标题
对氟达拉滨耐药的 B 细胞慢性淋巴细胞白血病患者对 2-氯脱氧腺苷的反应。
DOI：
--
复制
发表时间：
1992
影响因子：
158.5
通讯作者：
J. Liliemark
中科院分区：
文献类型：
--
作者：
G. Juliusson;A. Elmhorn‐Rosenborg;J. Liliemark
背景
未经治疗的B细胞慢性淋巴细胞白血病患者在给予卤代核苷类似物氟达拉滨后完全缓解率很高。然而，已证明对主要治疗无效的患者的预期寿命缩短，结局令人沮丧。
方法
我们连续治疗了4例对氟达拉滨和另一种卤代核苷类似物2-氯脱氧腺苷二线或后续治疗反应不满意的患者。
结果
1例患者尽管接受了10个疗程的氟达拉滨治疗，但仍出现淋巴细胞增多、贫血和血小板减少，经2-氯脱氧腺苷治疗后完全缓解。两名患者在接受6个疗程的氟达拉滨治疗后，缓解率低于部分缓解，但在接受2-氯脱氧腺苷治疗后，部分缓解率良好。1例Coombs阳性溶血性贫血患者，对3个疗程的氟达拉滨治疗无效，经2-氯脱氧腺苷治疗后部分缓解，低丙种球蛋白血症消退。
结论
尽管氟达拉滨和2-氯脱氧腺苷的结构相似，但没有证据表明它们之间存在交叉耐药。2-氯脱氧腺苷可诱导对化疗高度耐药的慢性淋巴细胞白血病的完全缓解，值得在此类患者中进行更广泛的临床评价。
BACKGROUND
Patients with untreated B-cell chronic lymphocytic leukemia have a high rate of complete remission when given the halogenated nucleoside analogue fludarabine. However, patients in whom the disease has proved refractory to primary treatment have a reduced life expectancy and a dismal outcome.
METHODS
We treated four consecutive patients who had unsatisfactory responses to second-line or subsequent treatment with fludarabine with another halogenated nucleoside analogue, 2-chlorodeoxyadenosine.
RESULTS
One patient with progressing lymphocytosis, anemia, and thrombocytopenia despite 10 courses of fludarabine entered a complete remission when treated with 2-chlorodeoxyadenosine. Two patients who had less-than-partial remissions after six courses of fludarabine had good partial remissions when treated with 2-chlorodeoxyadenosine. One patient with Coombs-positive hemolytic anemia who had no response to three courses of fludarabine had a partial remission, with resolution of hypogammaglobulinemia, when treated with 2-chlorodeoxyadenosine.
CONCLUSIONS
There was no evidence of cross-resistance between fludarabine and 2-chlorodeoxyadenosine despite their similar structures. 2-Chlorodeoxyadenosine may induce a complete remission in chronic lymphocytic leukemia that is highly resistant to chemotherapy, and it deserves wider clinical evaluation in patients with this condition.
2-氯脱氧腺苷：治疗慢性淋巴细胞白血病的有效新药。
影响因子：
20.3
作者：
Piro,LD;Carrera,CJ;Beutler,E;Carson,DA
通讯作者：
Carson,DA