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Antimetabolites
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Administered intravenously on alternate weeks, pentostatin is approved in the UK for the treatment of hairy cell leukemia and is capable of inducing prolonged remissions. It causes myelosuppression, immunosuppression, and several other side effects that can be severe.
Lymphocyte and plasma cell malignancies
Published in Gabriel Virella, Medical Immunology, 2019
Juan Carlos Varela, Gabriel Virella
The mainstay of therapy for hairy cell leukemia is the use of the purine nucleoside analogue 2-chlorodeoxyadenosine (cladribine). The combination of cladribine and rituximab has also been shown to be effective. In addition, deoxycoformycin (Pentostatin), an inhibitor of adenosine deaminase, and interferon-α are therapeutically useful in hairy cell leukemia.
Specific Therapy for Leukemias
Published in Tariq I Mughal, John M Goldman, Sabena T Mughal, Understanding Leukemias, Lymphomas, and Myelomas, 2017
Tariq I Mughal, John M Goldman, Sabena T Mughal
Most specialists (and patients) prefer cladrabine simply because it is administered in a single course as a continuous intravenous infusion over five to seven days. Very few patients require a second cycle. It has few side-effects, other than bone marrow suppression resulting in neutropenia, which is maximal a week after the therapy. Pentostatin is administered as an intravenous infusion every 14 days until a maximum response is observed in the bone marrow and then two additional cycles are administered. A subtle transformation sometime takes place in patients with hairy cell leukemia in the form of massive abdominal lymph nodes and resistance to cladrabine, pentostatin, and IFN-α treatment. The prognosis is often serious.
The pharmacological management of hairy cell leukemia
Published in Expert Opinion on Pharmacotherapy, 2020
Jorge Ramos Perez, Farhad Ravandi-Kashani
The purine nucleoside analogs cladribine and pentostatin transformed the treatment of hairy cell leukemia and remain the standard of care 30 years after its first use. They both cause an intercellular accumulation of deoxygenated adenosine triphosphate (dATP), a key component of DNA synthesis. Pentostatin inhibits the enzyme adenosine deaminase (ADA) and cladribine is an unphosphorylated adenosine (dAdo) analog that resists deamination by ADA. The end result is DNA strand breaks, inhibition of DNA repair, and apoptosis. Lymphoid cells have a relative deficiency of 5ʹ nucleotidase that provides selectivity to these purine analogs, and result in their incorporation into the DNA [30]. There are no published data to suggest cross-resistance between cladribine and pentostatin.
Long-term follow-up of patients with hairy cell leukemia in the south of Iran
Published in Expert Review of Hematology, 2023
Mehdi Dehghani, Ali Kashkooe, Nasrin Namdari, Reza Majidi, Mojtaba Karimi, Shirin Haghighat, Alireza Rezvani, Negar Safari
In a study by Else et al., the safety and efficacy of pentostatin and cladribine at a median follow-up of 12.5 years were compared. Along with the results of other published series, no differences in outcome were found [16]. Ten-year survival of patients treated with pentostatin and cladribine was estimated at 96% and 100%, respectively, with non-HCL-related deaths censored. In addition, reported preliminary results in eight patients with recurrent disease who were given the combination of either pentostatin or cladribine with rituximab [25], demonstrated improved response rate and relapse-free survival compared with the outcome in patients re-treated with single-agent pentostatin or cladribine.
Computational and experimental validation of morin as adenosine deaminase inhibitor
Published in Journal of Receptors and Signal Transduction, 2018
K. G. Arun, C. S. Sharanya, C. Sadasivan
Different types of ADA inhibitors have been reported from microorganisms, that includes coformycin [10], 2-deoxycoformycin or pentostatin [11] and IADA-7 [12]. Various ADA inhibitory compounds have been synthesized, including deaza adenosine derivatives [13], amino pyrazolopyrimidines [14], EHNA [erythro-9–(2-hydroxyl-3-nonyl) adenine [15] and adenine derivatives [16–18]. However, only pentostatin has been developed as a clinical drug for the treatment of lymphoma and leukemia but it is reported to be toxic [7].