A purine analog that inhibits adenosine deaminase.
Naturally occurring product up streptomyces antibioticus that acts by binding and inhibiting adenosine deaminase, an enzyme contained in all lymphoid cells necessary for purine metabolism.
Has activity in T-cell lymphomas, lymphoid malignancies, especially those involving the skin.
Initially treated patients for hairy cell leukemia have an overall response rate of 96%, with complete remission and push the response rate of 59% and 37%, respectively.
84% of hairy cell leukemia patients remain in remission at 4 years.
Large study show overall response rate from 84-100% with complete remission from 64 to 89%, and 10 year relapse free survival rate at 67-76% in those in whose disease are responding to treatment.
In combination with fludarabine leads to a high rate of pulmonary toxicity and is not a recommended treatment.
Combination of pentostatin, cyclophosphamide and rituximab induce high response rate in chronic lymphocytic leukemia associated first-line therapy.
Treatment is intravenous given on three consecutive days every four weeks or two consecutive days every two weeks.
Typical administration is 4 mg/m² intravenously as a bolus every other week for a total of 8-12 doses.
Associated with fever, cytopenias, vomiting, rash, paresthesias, and dysguesia.
Fever associated with use develops in 48% of patients, but only half have a documented infection.