2-Chlorodeoxyadenosine to Treat Refractory Histiocytosis X

To the Editor: Treatment of histiocytosis X is palliative at best. It includes corticosteroids, alkylating agents, antimetabolites, vinca alkaloids, and irradiation1. Since 2-chlorodeoxyadenosine, a purine substrate analogue active against lymphoid cancers,2 is toxic to monocytes in vitro,3 and since tissue histiocytes are derived from circulating monocytes as they move from the intravascular space to soft tissues, we administered 2-chlorodeoxyadenosine to a patient with histiocytosis X. A 33-year-old woman had presented at the age of 15 years with polyuria and polydipsia due to diabetes insipidus. Two years later vesiculopustular lesions developed on her gingiva, scalp, and vagina that were histologically . . .