Long-term analysis of the palliative benefit of 2-Chlorodeoxyadenosine (2-CdA) for myelofibrosis with myeloid metaplasia

Abstract

6620 Background:Therapeutic splenectomy in myelofibrosis with myeloid metaplasia (MMM) may result in extreme thrombocytosis and leukocytosis as well as accelerated hepatomegaly. We have previously reported on our short-term treatment experience with the purine nucleoside analog 2-chlorodeoxyadenosine (2-CdA) in such instances (Brit J Haem 1997;99(2):352.). We have since treated more patients with 2-CdA and provide information on the long-term treatment experience. Methods: 2-CdA was administered intravenously by way of either a continuous 7-day infusion (0.1 mg/kg/day) or a 5-day daily 2-hour infusion (5 mg/m2/day) for a planned 6 cycles of treatment. Results: Fourteen patients (median age 63 years; range 45–75) received 2-CdA therapy including 11 patients with prior splenectomy. The median number of 2-CdA treatment cycles was 4 (range 1–10). Nine patients (62 %) responded; 6 of the 11 splenectomized patients (55%) experienced a >50% reduction in palpable hepatomegaly, 3 of 6 patients (50%) with marked th...