Document Detail

2-Chlorodeoxyadenosine (cladribine)-related eosinophilia in patients with lymphoproliferative diseases.
MedLine Citation:
PMID:  9338619     Owner:  NLM     Status:  MEDLINE    
Eosinophilia and allergic skin reactions are uncommon events after 2-chlorodoxyadenosine (2-CdA, cladribine) administration. A multicentre retrospective analysis of eosinophilia in 360 patients treated with 2-CdA for lymphoid malignancies has been made. B-cell chronic lymphocytic leukaemia (B-CLL) was diagnosed in 153, hairy cell leukaemia (HCL) in 68, low-grade non-Hodgkin's lymphoma (LGNHL) in 119, high-grade NHL in 2 and Waldenstrom's macroglobulinaemia (WM) in 18 patients. 2-CdA was administered at a dose 0.12 mg/kg/d in 2-h intravenous infusion for 5 consecutive d. The courses were repeated monthly. Patients with HCL received 1 cycle of 2-CdA, with NHL 2-6 (mean 3.5) cycles and with B-CLL 3-6 (mean 5) cycles. Twenty patients (5.5%), including 5 with HCL, 6 with LGNHL, 7 with B-CLL and 2 with WM, developed peripheral blood eosinophilia. The mean values of absolute eosinophil count were 0.78x10(9)/l (0.58-1.06x10(9)/l), 0.71x10(9)/l (0.52-1.3x10(9)/l), 85 (0.56-1.82x10(9)/l) and 0.75 (0.74-0.76x10(9)/l), respectively. Eosinophilia occurred in 13 patients after 1 course, in 4 after 2 courses, and in 5 after > or =3 courses of the therapy. In 17 cases it resolved spontaneously. Allergic skin lesions with pruritus were noticed in 3 patients simultaneously with an increase in eosinophil count. All of them required antihistaminic drugs and/or corticosteroids. One patient with B-CLL experienced repeated episodes of eosinophilia. The highest incidence of 2-CdA-induced eosinophilia was noticed in patients with MW (11.1%) and HCL (7.4%) who received only 1 cycle of this drug and entered a complete remission. This side effect was less frequently observed in LGNHL and B-CLL, i.e. in 5.0% and 4.6% of cases, respectively. The mechanism of 2-CdA-induced eosinophilia is not clear. It has been postulated that massive tumour cell lysis may trigger a release of IL-5 and probably other cytokines. The allergic mechanism of 2-CdA-induced eosinophilia is also possible, especially in patients with simultaneous skin reactions.
T Robak; M Błasińska-Morawiec; E Krykowski; A Hellmann; K Lewandowski; A Dmoszyńska; M Adamczyk-Cioch; M Kazimierczak; E Trepińska; M Dwilewicz-Trojaczek; Z Kuratowska; A B Skotnicki; W S Nowak; B Zdziarska; I Urasiński
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of haematology     Volume:  59     ISSN:  0902-4441     ISO Abbreviation:  Eur. J. Haematol.     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-11-03     Completed Date:  1997-11-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8703985     Medline TA:  Eur J Haematol     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  216-20     Citation Subset:  IM    
Department of Hematology, Medical University of Lodź, Poland.
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MeSH Terms
2-Chloroadenosine / administration & dosage,  adverse effects,  analogs & derivatives*
Antimetabolites, Antineoplastic / administration & dosage,  adverse effects*
Deoxyadenosines / administration & dosage,  adverse effects*
Eosinophilia / blood,  chemically induced*,  physiopathology
Infusions, Intravenous
Leukocyte Count
Lymphoproliferative Disorders / drug therapy*
Middle Aged
Retrospective Studies
Reg. No./Substance:
0/Antimetabolites, Antineoplastic; 0/Deoxyadenosines; 115044-75-2/2-chloro-3'-deoxyadenosine; 146-77-0/2-Chloroadenosine

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