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Pentostatin

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Pentostatin, Nipent, 2'-deoxycoformycin

  • See Also
  1. Chemotherapy
  2. Antimetabolite Chemotherapy
  • Indications
  1. FDA Approved (in combination regimens)
    1. Hairy Cell Leukemia
  2. Off-Label Use
    1. Graft Versus Host Disease (acute or chronic)
    2. Chronic Lymphocytic Leukemia (CLL)
    3. Cutaneous T-Cell Lymphoma
    4. Mycosis Fungoides
    5. T-Cell Prolymphocytic Leukemia
  • Mechanism
  1. Purine Nucleotide analog
    1. Extracted from bacterium Streptomyces antibioticus
    2. More active in lymph cells, esp. T-Cells, and esp. malignant T Cells and CD26+ Lymphocytes
  2. Inhibits adenine deaminase (ADA)
    1. Blocks Purine metabolism
    2. Increases intracellular dATP levels, inhibiting ribonucleotide reductase
    3. Inhibits DNA synthesis
    4. Inhibits RNA synthesis
  • Medications
  1. Pentostatin powder for IV Solution in 10 mg vials
  • Dosing
  1. See other references for disease specific dosing protocols
  • Adverse Effects
  1. Alopecia
  2. Myelosuppression
  3. Hepatotoxicity
  4. Impaired future fertility
  5. Lung Toxicity
  6. Nephrotoxicity
  7. Neurotoxicity (CNS)
  8. Rash (severe)
  • Safety
  1. Avoid in Pregnancy (any trimester)
    1. Use reliable Contraception
  2. Avoid in Lactation
  3. Monitoring
    1. Complete Blood Count
    2. Renal Function Tests
  • Resources
  1. Pentostatin (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=674e0e6d-46ed-4868-9196-04019d667716
  • References
  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia