Adenosine analogues

Three adenosine analogues have come into clinical practice, active in low-grade NHL, Waldenstrom's macroglobulinaemia, and CLL. All have similar effects and interact with enzyme adenosine deaminase (ADA), a deficiency of which causes severe combined immunodeficiency. Toxicity includes myelosuppression with particular effects on lymphocytes, including depression of CD3 and CD4 levels, and reduced NK activity. Infective complications are more likely to be opportunistic than with most cytotoxics. Neurotoxicity can occur, usually, but not exclusively, associated with higher doses.

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