Purpose: To assess the activity of 2-chlorodeoxyadenosine (2CdA) as primary therapy for patients with Waldenstrim's macroglobulinemia. Patients and Methods: 2CdA was given to 26 consecutive, previously untreated and symptomatic patients with Waldenstr6m's macroglobulinemia. Two courses were administered to outpatients at a dose of 0.1 mg/ kg body weight per day for a 7-day continuous infusion using a portable pump through a central venous catheter. Responding patients were followed up without further therapy and were scheduled to receive two additional treatments with 2CdA on disease relapse. Results: Twenty-two of 26 patients responded to the 2C-ildrapy (85%; 95% confidence interval [CI], 65% to 96%), including three patients who achieved a complete W ALDENSTROM'S macroglobulinemia is a smallcell lymphocytic lymphoma that produces monoclonal immunoglobulin M (IgM). The disease usually affects older persons and may cause symptoms due to anemia, lymphadenopathy, or elevated serum viscosity. 1 Chemotherapy with alkylating agents and steroids has been the standard therapy for patients with symptomatic macroglobulinemia and has induced responses in about one half of previously untreated patients. Courses have been usually administered intermittently for long periods and have exposed patients to the risks of myelosuppression and rarely secondary leukemia.2-6 We have recently reported that the nucleoside analog 2chlorodeoxyadenosine (2CdA) was active in 40% of patients with macroglobulinemia who had failed previous therapies. 7 A few previously untreated patients were included in this study, and their disease appeared to be sensitive to this agent. Based on this encouraging experience, we studied 2CdA as the initial therapy for a larger number of patients with Waldenstriim's macroglobulinemia.
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