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Original Research |15 September 1994

2-Chlorodeoxyadenosine-Induced Complete Remissions in Langerhans-Cell Histiocytosis

Alan Saven, MD; Kenneth A. Foon, MD; Lawrence D. Piro, MD

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Author, Article, and Disclosure Information
Copyright ©2004 by the American College of Physicians
2004
  • From Scripps Clinic and Research Foundation, La Jolla, California and the University of Kentucky, Lexington, Kentucky. Requests for Reprints: Alan Saven, MD, Scripps Clinic and Research Foundation, 10666 North Torrey Pines Road, La Jolla, CA 92037. Acknowledgments: The authors thank Mary-Helen Hader for data collection.
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Langerhans-cell histiocytosis results from the proliferation and accumulation of tissue histiocytes, clinically manifested as osteolytic lesions, hypothalamic insufficiency, and seborrheic and vesiculopustular lesions on the scalp, perineum, rectum, and vulva [1]. Treatment has been palliative and includes corticosteroids, alkylating agents, antimetabolites, vinca alkaloids, and irradiation [2]. Combination chemotherapy offers no advantage over the use of single agents and is associated with greater toxicity. 2-Chlorodeoxyadenosine (2-CdA) (cladribine, Leustatin [Ortho Biotech, Raritan, New Jersey]), a purine analog with activity in indolent lymphoproliferative disorders and myeloid leukemias [3, 4], is potently toxic to monocytes in vitro [5]. Because tissue histiocytes are derived from the same stem cells as circulating monocytes, 2-CdA was a rational therapeutic option [6]. We therefore administered 2-CdA to three patients with Langerhans-cell histiocytosis.
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Saven A, Foon KA, Piro LD. 2-Chlorodeoxyadenosine-Induced Complete Remissions in Langerhans-Cell Histiocytosis. Ann Intern Med. ;121:430–432. doi: 10.7326/0003-4819-121-6-199409150-00006

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Published: Ann Intern Med. 1994;121(6):430-432.

DOI: 10.7326/0003-4819-121-6-199409150-00006

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