2-Chlorodeoxyadenosine treatment after splenectomy in patients who have myelofibrosis with myeloid metaplasia

Ayalew Tefferi, Murray N. Silverstein, Chin Yang Li

Research output: Contribution to journalArticlepeer-review

55 Scopus citations

Abstract

2-Chlorodeoxyadenosine (2-CdA) is a purine nucleoside analogue with therapeutic activity in low-grade lymphoproliferative disorders. In addition, 2-CdA has a potent myelosuppressive effect, and it has been shown to be toxic to malignant myeloid cells both in vitro and in vivo. In this pilot study we treated nine patients who had advanced myelofibrosis with myeloid metaplasia (MMM) and progressive hepatomegaly or symptomatic thrombocytosis after therapeutic splenectomy. 2-CdA was administered at 0.05-0.1 mg/kg/d for 7d for one to five treatment cycles. A reduction in liver size associated with marked improvement in fatigue and control of thrombocytosis and leucocytosis was achieved in seven of the nine patients (78% response rate). In four of the seven responding patients the reduction in liver size was durable (4-28 months) and was associated with a decrease in serum alkaline phosphatase levels. However, no patient had improvement in anaemia, and two of the seven initially responding patients have since, died of acute leukaemia or progressive disease. Improvement in bone marrow fibrosis was noted in two of five available post-treatment marrow examinations. Toxicity was mainly myelosuppression, which was severe in two patients, 2-Cola may be considered a palliative therapeutic agent after splenectomy in noncytopenic patients with MMM who have progressive hepatomegaly or extreme thrombocytosis.

Original languageEnglish (US)
Pages (from-to)352-357
Number of pages6
JournalBritish journal of haematology
Volume99
Issue number2
DOIs
StatePublished - 1997

Keywords

  • 2-chlorodeoxyadenosine
  • Hepatomegaly
  • Myelofibrosis with myeloid metaplasia
  • Splenectomy
  • Thrombocytosis

ASJC Scopus subject areas

  • Hematology

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