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pubmed-article:9255268pubmed:abstractTextCladribine (2-chlorodeoxyadenosine;) is a purine analogue with clinical activity against hairy cell leukemia, chronic lymphocytic leukemia and indolent lymphoma. To clarify the toxicity profiles of cladribine, we conducted a phase I and pharmacological study of cladribine with a schedule of seven-day continuous intravenous infusion every 28 days up to a maximum of three cycles. We enrolled 10 previously-treated patients with various lymphoid malignancies. No dose-limiting toxicity (grade 4 hematologic and/or grade 3 or more non-hematologic) was observed in the three patients who received 0.06 mg/kg/day (Level 1). Of the seven patients who received 0.09 mg/kg/day (Level 2), one patient developed grade 4 hypoxemia and grade 4 thrombocytopenia, and another developed grade 4 neutropenia. Of the seven patients treated at Level 2, one with cutaneous T-cell lymphoma attained complete remission, and one with mantle cell lymphoma, one with chronic lymphocytic leukemia and one with adult T-cell leukemia-lymphoma attained partial remission. A pharmacokinetic analysis of the seven patients without leukemic cells showed that their area under the concentration versus time curves of plasma cladribine increased dose-dependently from 2661.3 +/- 300.4 nM x h at Level 1 (n = 3) to 3411.3 +/- 341.0 nM x h at Level 2 (n = 4) (P = 0.034). We conclude that the recommended phase II dose of cladribine (0.09 mg/kg/day as a seven-day continuous i.v. infusion) in Caucasian patients can be safely administered to Japanese patients. The encouraging results prompted us to plan subsequent phase II studies of cladribine against adult T-cell leukemia-lymphoma, hairy cell leukemia and indolent lymphoma.lld:pubmed
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pubmed-article:9255268pubmed:authorpubmed-author:KobayashiYYlld:pubmed
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pubmed-article:9255268pubmed:volume27lld:pubmed
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pubmed-article:9255268pubmed:pagination146-53lld:pubmed
pubmed-article:9255268pubmed:dateRevised2007-11-15lld:pubmed
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pubmed-article:9255268pubmed:year1997lld:pubmed
pubmed-article:9255268pubmed:articleTitlePhase I study of cladribine (2-chlorodeoxyadenosine) in lymphoid malignancies. Cladribine Study Group.lld:pubmed
pubmed-article:9255268pubmed:affiliationDepartment of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.lld:pubmed
pubmed-article:9255268pubmed:publicationTypeJournal Articlelld:pubmed
pubmed-article:9255268pubmed:publicationTypeClinical Triallld:pubmed
pubmed-article:9255268pubmed:publicationTypeResearch Support, Non-U.S. Gov'tlld:pubmed
pubmed-article:9255268pubmed:publicationTypeMulticenter Studylld:pubmed
pubmed-article:9255268pubmed:publicationTypeClinical Trial, Phase Illd:pubmed