Cladribine (2-CdA, 2-chlorodeoxyadenosine) is a purine nucleoside analog
of high efficacy in lymphoid and myeloid malignancies. In contrast to other purine
nucleoside analogs, 2-CdA is equally cytotoxic to both proliferating and quiescent cells.
In addition, recent data indicates that a combination of 2-CdA with other cytotoxic
agents and monoclonal antibodies shows synergistic proapoptotic and cytotoxic activity
on lymphoid and myeloid neoplastic cells. Cladribine is the drug of choice in the
treatment of hairy cell leukemia. It is also useful in other lymphoid and myeloid
neoplasms, including chronic lymphocytic leukemia, Waldenström macroglobulinemia,
and non-Hodgkin lymphoma. In addition, 2-CdA has been found to be effective in
Sezary syndrome and mycosis fungoides. Moreover, several investigations have
revealed that the agent is active in acute myeloid leukemia, Langerhans cell
histiocytosis, and systemic mastocytosis. This chapter will summarize the current status
of 2-CdA in the treatment of hematologic malignancies.
Keywords: 2-CdA, Acute myeloid leukemia, Chronic lymphocytic leukemia,
Cladribine, Hairy cell leukemia, Langerhans cell histiocytosis, Lymphoma,
Systemic mastocytosis, Waldenström macroglo-bulinemia.
