Pentostatin: An Adenosine Deaminase Inhibitor for the Treatment of Hairy Cell Leukemia

OBJECTIVE:To review the pharmacology, pharmacokinetics, adverse effects, and various dosage regimens of pentostatin, and to evaluate the role of pentostatin in the treatment of hairy cell leukemia (HCL).DATA IDENTIFICATION:Articles were identified via an English-language literature search of MEDLINE (1966–91) and an extensive search of bibliographies from identified articles.STUDY SELECTION:Human clinical trials and case reports were selected for evaluation.DATA EXTRACTION:The literature was assessed for quality, methodology, and outcome information.DATA SYNTHESIS:At dosages of 4 mg/m2 administered every other week for 6–9 months, pentostatin has been shown to successfully induce a complete response in 58–90 percent of patients and to produce a partial response in up to 30 percent of patients with HCL. The median time to achieve a response is 4.7 months. Long-term remissions of at least 14 months' duration have occurred in some patients. Compared with interferon alfa alone, total response rates are not si...