Purine analogs in the treatment of low-grade lymphomas and chronic lymphocytic leukemias.

The purine analogs fludarabine (FAMP), 2-chlorodeoxy-adenosine (2-CDA) and 2-deoxycoformycin (DCF) comprise a novel group of agents with high activity in low-grade lymphoid malignancies. Although all three agents share several mechanisms of action, such as the induction of apoptosis, and toxic effects, such as prolonged immunosuppression, their activity appears to be different in different disorders. While FAMP and possibly also 2-CDA are highly active in chronic lymphocytic leukemia and low-grade follicular lymphomas, 2-CDA and DCF are most effective in hairy cell leukemia.

Fludarabine in the management of malignant lymphomas.

Fludarabine has revealed significant single agent activity in non-Hodgkin's lymphomas (NHL) in a variety of clinical phase I/II studies. Its efficacy appears most pronounced in low grade NHL and the follicular subtype in particular as well as in Waldenström's macroglobulinaemia. In these disorders, response rates range from 31 to 67% in previously treated patients, and up to 75% in previously untreated patients.