Cladribine (2-CdA) Effectiveness in Patients with Low Grade Non-Hodgkin’s Lymphoma - 7 year Polish Study Report.

2-Chlorodeoxyadenosine (2-CdA, Cladribine) was used in patients with advanced, low-grade lymphomas (Lymphoplasmacytoid, Centroblastic/centrocytic, Centrocytic, Lymphocytic) resistant to conventional therapy. There was conducted a trial of 2-CdA group versus control group (patients treated different chemotherapy: Chlorambucil, COP, CHOP) in 85 patients. There were 47 men and 38 women with median age of 55 years were treated. Forty five patients with low-grade lymphomas were given 2-CdA at 0.1 mg/kg/d as a 7–5 day continuous infusion every 4–6 weeks. A total number of courses was different (2–7), median of three courses per patient, of 2-CdA were administered. All patients were evaluable for toxicity and for response.

The results of overall response for 2-CdA group and control group are in table 1.

Table 1- The results of overall response for 2-CdA group and control group

The results of 2-CdA therapy are showed in tabel 2.

Table 2 - The results of 2-CdA therapy in low grade NHL patients.

The results of 2-CdA therapy LG NHL patients (I-6pts; II-7pts.; III-25pts.; IV-7 pts.) concerned with clinical stage are showed below:

Clinical Stage-CR (%)

I-50

II-42.9

III-12

IV-14.3

P>0.05

Clinical Stage-PR (%)

I-33.3

II-42.9

III-40.0

IV-28.6

P>0.05

Toxicity, in particular opportunistic infections (< or = grade 2, 35.6–48.4% in 2-CdA group v 31.6–64.7% in chemotherapy treated group; P>0.05) and myelosuppression (< or = grade 2 leucopenia, 31.1% in 2-CdA group v 25.0% in chemotherapy treated group, P>0.05 and thrombocytopenia 0–II grade WHO), were more frequent in 2-CdA group (II–III line therapy). The median response duration was 12 months (range, 3 to 44+). I observed less death numbers in 2-CdA first line patients than II–III line 2-CdA group (P=.00132).

Conclusions : There was no statistical significant difference in frequency overall response (CR+PR) between 2-CdA group and chemotherapy treated group.

2-CdA therapy as a consecutive line caused an increase in mortality risk in contrast to the first line therapy.

2-CdA therapy as II–III line therapy allowed to receive complete remission in 9.4% previously treated low grade non Hodkin’s lymphoma patients.