Abstract
This report describes two cases of T-cell chronic lymphocytic leukemia (T-CLL) treated with purine nucleoside analogues. One patient had CD8+, CD3+ large granular lymphocytosis (LGL) producing transfusion-dependent anemia and was refractory to chemotherapy. Treatment with four cycles of fludarabine produced a clinical complete remission and a molecular genetic partial remission that has been durable for > 15 months. The other patient had CD4+ T-prolymphocytic leukemia and was unresponsive to both fludarabine and 2-chlorodeoxyadenosine. Further trials of these agents are warranted in T-CLL, especially the LGL variant.
MeSH terms
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2-Chloroadenosine / analogs & derivatives*
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2-Chloroadenosine / therapeutic use
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Anemia / drug therapy
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Anemia / etiology
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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CD3 Complex
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CD4-Positive T-Lymphocytes
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CD8-Positive T-Lymphocytes
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Cyclophosphamide / administration & dosage
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Deoxyadenosines / therapeutic use*
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Fatal Outcome
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Female
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Humans
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Immunophenotyping
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Leukemia, Prolymphocytic / drug therapy*
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Leukemia, Prolymphocytic / pathology
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Leukemia, Prolymphocytic, T-Cell / complications
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Leukemia, Prolymphocytic, T-Cell / drug therapy*
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Leukemia, Prolymphocytic, T-Cell / pathology
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Male
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Methotrexate / administration & dosage
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Middle Aged
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Neoplastic Stem Cells / drug effects
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Neoplastic Stem Cells / pathology
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Prednisone / administration & dosage
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Salvage Therapy
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Vidarabine / analogs & derivatives*
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Vidarabine / therapeutic use
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Vincristine / administration & dosage
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Zidovudine / administration & dosage
Substances
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CD3 Complex
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Deoxyadenosines
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2-Chloroadenosine
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Zidovudine
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Vincristine
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Cyclophosphamide
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Vidarabine
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2-chloro-3'-deoxyadenosine
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fludarabine
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Prednisone
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Methotrexate