CHLORODEOXYADENOSINE THERAPY OF PATIENTS WITH WALDENSTROM MACROGLOBULINEMIA PREVIOUSLY TREATED WITH FLUDARABINE

Background: Fludarabine monophosphate and 2Chlorodeoxyadenosine are nucleoside analogues with activity against Waldenstrom macroglobulinemia. However, it is not clear whether prior exposure to one analogue precludes response to the other compound. Patients and methods: Fourteen patients with Waldenstrom's macroglobulinemia and prior exposure to fludarabine were treated with two courses of 2chlorodeoxyadenosine. Results: Three out of four patients that had previously responded to fludarabine and were relapsing from unmaintained remission, achieved a partial response with 2chlorodeoxyadenosine therapy. However, only one out of 10 patients with disease resistant to fludarabine responded to 2chlorodeoxyadenosine. Conclusions: 2chlorodeoxyadenosine may be effective in patients with Waldenstrom macroglobulinemia sensitive to fludarabine. However, this compound has limited activity for patients with disease resistant to fludarabine.