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Purine nucleoside analogues: fludarabine, pentostatin, and cladribine

Part 2: Pentostatin

School of Pharmacy, University of Wisconsin, Madison, Wisconsin

Ashley K. Morris

University of Texas Health Science Center, Clinical Pharmacy Programs, San Antonio, Texas, Audie Murphy Veterans Affairs Hospital, San Antonio, Texas

John G. Kuhn

University of Texas Health Science Center, Clinical Pharmacy Programs, San Antonio, Texas

Purpose. The primary objective of this article is to continue the discussion of the pharmacology, phar macokinetics, clinical use, and adverse effects of the currently approved adenosine analogues, focusing on pentostatin. This is part two of a three part series.

Data Sources. We reviewed the literature through a MEDLINE search from 1986 to 1996. Rele vant articles cited in the literature obtained by MED LINE searching also were considered. We searched the following terms: fludarabine, cladribine, pentosta tin, apoptosis, and adenosine analogues. The search was restricted to the English language.

Data Extraction. We have reviewed the current literature in regard to the chemistry, mechanisms of action and pharmacology, pharmacokinetics, clinical use, adverse effects, drug interactions, indications, formulation, dosage, administration, and pharmaceu tical issues of the currently approved adenosoine analogues, focusing on pentostatin.

Data Synthesis. The adenosine analogues are structurally similar agents used in the management of hematological malignancies. Pentostatin and cladrib ine are both active agents in the treatment of hairy cell leukemia. There are no comparative clinical trials between the agents, and we have provided compari sons based on pharmacology, clinical experience, adverse effects, and cost.

Key Words: Pentostatin • purine nucleoside analogues • fludarabine • cladribine.

Journal of Oncology Pharmacy Practice, Vol. 2, No. 4, 211-224 (1996)
DOI: 10.1177/107815529600200403


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