Document Detail


Relationship between cladribine (CdA) plasma, intracellular CdA-5'-triphosphate (CdATP) concentration, deoxycytidine kinase (dCK), and chemotherapeutic activity in chronic lymphocytic leukemia (CLL).
MedLine Citation:
PMID:  9598154     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Seventeen patients with CLL were treated with oral 2-chloro-2'-deoxyadenosine (cladribine, CdA, 10 mg/m2) on 3 consecutive days and the pharmacokinetic parameters of CdA in patient plasma and its intracellular nucleotides (CdAMP, CdATP) in circulating leukemic cells were studied after the last dose intake and up to 72 h thereafter. The median terminal half life (t1/2) of CdA in plasma was 21.1 h and the area under the curve (AUC) was median 1.2 microMh. The median t1/2 was 14.6 h for CdAMP and 9.7 h for CdATP. The AUC of CdATP in leukemic cells is lower than the AUC of CdAMP (median ratio 0.60). There was no correlation between cellular CdATP and plasma CdA concentrations or dCK activity. The clinical response was related to higher Cmax values for plasma CdA (p = 0.05) and higher products of dCK activity and CdA Cmax of plasma (p = 0.02). The activity of dCK alone was not related to the clinical outcome in this patient group. The results suggest that further steps in the mechanism of action of CdA beyond its bioactivation may be more important, e.g. the extent of DNA fragmentation or the ability of the leukemic cell to go into apoptosis, than the concentration of CdA nucleotides alone.
Authors:
F Albertioni; S Lindemalm; S Eriksson; G Juliusson; J Liliemark
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Advances in experimental medicine and biology     Volume:  431     ISSN:  0065-2598     ISO Abbreviation:  Adv. Exp. Med. Biol.     Publication Date:  1998  
Date Detail:
Created Date:  1998-07-23     Completed Date:  1998-07-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0121103     Medline TA:  Adv Exp Med Biol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  693-7     Citation Subset:  IM    
Affiliation:
Department of Clinical Pharmacology, Karolinska Hospital, Stockholm, Veterinary Medical Chemistry, Linköping, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adenine Nucleotides / blood
Adenosine Triphosphate / analogs & derivatives*,  blood
Antineoplastic Agents / blood,  pharmacokinetics,  therapeutic use*
Cladribine / analogs & derivatives*,  blood,  pharmacokinetics,  therapeutic use*
Deoxycytidine Kinase / metabolism*
Female
Half-Life
Humans
Kinetics
Leukemia, Lymphocytic, Chronic, B-Cell / blood,  drug therapy*,  enzymology
Leukocytes, Mononuclear / metabolism
Male
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adenine Nucleotides; 0/Antineoplastic Agents; 0/cladribine triphosphate; 4291-63-8/Cladribine; 56-65-5/Adenosine Triphosphate; EC 2.7.1.74/Deoxycytidine Kinase

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