Cladribine is a purine nucleoside analogue that is resistant to cellular catabolism. Through diverse mechanisms, cladribine is equally toxic to dividing and nondividing cells, making it highly active in indolent lymphoproliferative diseases. In clinical practice, cladribine is mostly used in the treatment of hairy cell leukemia and Waldenström’s macroglobulinemia. However, its remarkable activity in follicular lymphoma and other indolent non-Hodgkin’s lymphoma subtypes has not been more widely appreciated. Cladribine compares favorably to other standard treatments for these conditions.
Cladribine is in a phase II study for matnle lymphoma as a single agent, NCT00002879. A 2006 preliminary report suggested that caldribine in combination with rituximab regimens were highly effective and well tolerated modalities of treatment in heavily pretreated patients with indolent lymphoproliferative disorders.
Darren S Sigal and Alan Saven Cladribine in indolent non-Hodgkin’s lymphomaExpert Review of Anticancer Therapy April 2008, Vol. 8, No. 4, Pages 535-545
Robak T, Smolewski P, Cebula B, Szmigielska-Kaplon A, Chojnowski K, Blonski JZ.
Rituximab combined with cladribine or with cladribine and cyclophosphamide in heavily pretreated patients with indolent lymphoproliferative disorders and mantle cell lymphoma.Cancer. 2006 Oct 1;107(7):1542-50.