Treatment of indolent non-Hodgkin's lymphoma with cladribine as single-agent therapy and in combination with mitoxantrone

James Olen Armitage, Kensei Tobinai, Dieter Hoelzer, Mathias J. Rummel

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

The term indolent in describing a non-Hodgkin's lymphoma (NHL) generally refers to a group of B-cell NHLs composed of predominantly small cells that make up several categories, including follicular lymphoma, small lymphocytic lymphoma, and lymphoma of mucosa-associated lymphoid tissue. Most patients with follicular lymphoma respond to therapy, and the average survival time in large series is approximately 10 years. Patients who achieve a complete remission with initial treatment have an approximately 25% chance of remaining free of disease for 10 years. However, this means that more than 80% of patients will require salvage therapy. Cladribine is a newer purine analogue and is of particular interest because it is resistant to deamination by adenosine deaminase. It is cytotoxic to both proliferating and resting lymphocytes, making it an attractive agent for the treatment of indolent NHL. In this review article, we summarize the current treatment approaches for indolent NHL and the results of cladribine monotherapy studies in Japan and cladribine studies in Germany that have focused on a combination therapy with mitoxantrone. Cladribine is a potent inhibitor of DNA repair. The combination of a DNA-damaging agent with an inhibitor of DNA repair constitutes the rationale for combining cladribine with mitoxantrone. A German study has demonstrated that the combination of reduced-dose cladribine and mitoxantrone is a highly active regimen with favorable toxicity profiles. Cladribine is highly effective as a single agent and in combination with mitoxantrone in the treatment of indolent NHL, and its availability broadens the range of therapeutic options for indolent NHL.

Original languageEnglish (US)
Pages (from-to)311-321
Number of pages11
JournalInternational Journal of Hematology
Volume79
Issue number4
DOIs
StatePublished - May 2004

Fingerprint

Cladribine
Mitoxantrone
Non-Hodgkin's Lymphoma
Follicular Lymphoma
DNA Repair
Therapeutics
Salvage Therapy
Marginal Zone B-Cell Lymphoma
Deamination
Adenosine Deaminase
B-Cell Chronic Lymphocytic Leukemia
Germany
Japan
B-Lymphocytes
Lymphocytes
Survival
DNA

Keywords

  • 2-CdA
  • Cladribine
  • Indolent lymphoma
  • Mitoxantrone

ASJC Scopus subject areas

  • Hematology

Cite this

Treatment of indolent non-Hodgkin's lymphoma with cladribine as single-agent therapy and in combination with mitoxantrone. / Armitage, James Olen; Tobinai, Kensei; Hoelzer, Dieter; Rummel, Mathias J.

In: International Journal of Hematology, Vol. 79, No. 4, 05.2004, p. 311-321.

Research output: Contribution to journalReview article

@article{bfde690153f441878254b005fd6c87f3,
title = "Treatment of indolent non-Hodgkin's lymphoma with cladribine as single-agent therapy and in combination with mitoxantrone",
abstract = "The term indolent in describing a non-Hodgkin's lymphoma (NHL) generally refers to a group of B-cell NHLs composed of predominantly small cells that make up several categories, including follicular lymphoma, small lymphocytic lymphoma, and lymphoma of mucosa-associated lymphoid tissue. Most patients with follicular lymphoma respond to therapy, and the average survival time in large series is approximately 10 years. Patients who achieve a complete remission with initial treatment have an approximately 25{\%} chance of remaining free of disease for 10 years. However, this means that more than 80{\%} of patients will require salvage therapy. Cladribine is a newer purine analogue and is of particular interest because it is resistant to deamination by adenosine deaminase. It is cytotoxic to both proliferating and resting lymphocytes, making it an attractive agent for the treatment of indolent NHL. In this review article, we summarize the current treatment approaches for indolent NHL and the results of cladribine monotherapy studies in Japan and cladribine studies in Germany that have focused on a combination therapy with mitoxantrone. Cladribine is a potent inhibitor of DNA repair. The combination of a DNA-damaging agent with an inhibitor of DNA repair constitutes the rationale for combining cladribine with mitoxantrone. A German study has demonstrated that the combination of reduced-dose cladribine and mitoxantrone is a highly active regimen with favorable toxicity profiles. Cladribine is highly effective as a single agent and in combination with mitoxantrone in the treatment of indolent NHL, and its availability broadens the range of therapeutic options for indolent NHL.",
keywords = "2-CdA, Cladribine, Indolent lymphoma, Mitoxantrone",
author = "Armitage, {James Olen} and Kensei Tobinai and Dieter Hoelzer and Rummel, {Mathias J.}",
year = "2004",
month = "5",
doi = "10.1532/IJH97.04050",
language = "English (US)",
volume = "79",
pages = "311--321",
journal = "International Journal of Hematology",
issn = "0925-5710",
publisher = "Springer Japan",
number = "4",

}

TY - JOUR

T1 - Treatment of indolent non-Hodgkin's lymphoma with cladribine as single-agent therapy and in combination with mitoxantrone

AU - Armitage, James Olen

AU - Tobinai, Kensei

AU - Hoelzer, Dieter

AU - Rummel, Mathias J.

PY - 2004/5

Y1 - 2004/5

N2 - The term indolent in describing a non-Hodgkin's lymphoma (NHL) generally refers to a group of B-cell NHLs composed of predominantly small cells that make up several categories, including follicular lymphoma, small lymphocytic lymphoma, and lymphoma of mucosa-associated lymphoid tissue. Most patients with follicular lymphoma respond to therapy, and the average survival time in large series is approximately 10 years. Patients who achieve a complete remission with initial treatment have an approximately 25% chance of remaining free of disease for 10 years. However, this means that more than 80% of patients will require salvage therapy. Cladribine is a newer purine analogue and is of particular interest because it is resistant to deamination by adenosine deaminase. It is cytotoxic to both proliferating and resting lymphocytes, making it an attractive agent for the treatment of indolent NHL. In this review article, we summarize the current treatment approaches for indolent NHL and the results of cladribine monotherapy studies in Japan and cladribine studies in Germany that have focused on a combination therapy with mitoxantrone. Cladribine is a potent inhibitor of DNA repair. The combination of a DNA-damaging agent with an inhibitor of DNA repair constitutes the rationale for combining cladribine with mitoxantrone. A German study has demonstrated that the combination of reduced-dose cladribine and mitoxantrone is a highly active regimen with favorable toxicity profiles. Cladribine is highly effective as a single agent and in combination with mitoxantrone in the treatment of indolent NHL, and its availability broadens the range of therapeutic options for indolent NHL.

AB - The term indolent in describing a non-Hodgkin's lymphoma (NHL) generally refers to a group of B-cell NHLs composed of predominantly small cells that make up several categories, including follicular lymphoma, small lymphocytic lymphoma, and lymphoma of mucosa-associated lymphoid tissue. Most patients with follicular lymphoma respond to therapy, and the average survival time in large series is approximately 10 years. Patients who achieve a complete remission with initial treatment have an approximately 25% chance of remaining free of disease for 10 years. However, this means that more than 80% of patients will require salvage therapy. Cladribine is a newer purine analogue and is of particular interest because it is resistant to deamination by adenosine deaminase. It is cytotoxic to both proliferating and resting lymphocytes, making it an attractive agent for the treatment of indolent NHL. In this review article, we summarize the current treatment approaches for indolent NHL and the results of cladribine monotherapy studies in Japan and cladribine studies in Germany that have focused on a combination therapy with mitoxantrone. Cladribine is a potent inhibitor of DNA repair. The combination of a DNA-damaging agent with an inhibitor of DNA repair constitutes the rationale for combining cladribine with mitoxantrone. A German study has demonstrated that the combination of reduced-dose cladribine and mitoxantrone is a highly active regimen with favorable toxicity profiles. Cladribine is highly effective as a single agent and in combination with mitoxantrone in the treatment of indolent NHL, and its availability broadens the range of therapeutic options for indolent NHL.

KW - 2-CdA

KW - Cladribine

KW - Indolent lymphoma

KW - Mitoxantrone

UR - http://www.scopus.com/inward/record.url?scp=2942578934&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=2942578934&partnerID=8YFLogxK

U2 - 10.1532/IJH97.04050

DO - 10.1532/IJH97.04050

M3 - Review article

C2 - 15218957

AN - SCOPUS:2942578934

VL - 79

SP - 311

EP - 321

JO - International Journal of Hematology

JF - International Journal of Hematology

SN - 0925-5710

IS - 4

ER -