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a highly toxic antitumor antibiotic administered intravenously in the treatment of refractory hairy cell leukemia.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.



Pharmacologic class: Antimetabolite

Therapeutic class: Antineoplastic

Pregnancy risk category D

FDA Box Warning

• Give under supervision of physician experienced in cancer chemotherapy, in facility with adequate diagnostic and treatment resources.

• Use of higher dosages than those specified isn't recommended, as dose-limiting severe renal, liver, pulmonary, and CNS toxicities may occur.

• In study of patients with refractory chronic lymphocytic leukemia receiving drug at recommended dosage in combination with fludarabine, four of six patients had severe or fatal pulmonary toxicity. Use in combination with fludarabine isn't recommended.


Unknown. Thought to inhibit adenosine deaminase, thereby increasing levels of deoxyadenosine triphosphate in cells, blocking DNA synthesis, and inhibiting ribonucleotide reductase.


Powder for injection: 10-mg vials

Indications and dosages

Hairy cell leukemia

Adults: 4 mg/m2 I.V. every other week


• Hypersensitivity to drug


Use cautiously in:

• renal disease, bone marrow depression

• pregnant or breastfeeding patients

• children.


• Before giving, hydrate patient with 500 to 1,000 ml of dextrose 5% and normal saline solution (or its equivalent). After administering, give 500 ml of dextrose 5% in water (D5W) or its equivalent.

Follow facility protocol for handling, administering, and disposing of chemotherapeutic drugs.

• Give by direct I.V. bolus injection or dilute with 25 to 50 ml of D5W or normal saline solution; infuse over 20 to 30 minutes.

Adverse reactions

CNS: headache, malaise, anxiety, confusion, depression, dizziness, insomnia, nervousness, paresthesia, drowsiness, abnormal thinking, fatigue, asthenia, hallucinations, hostility, amnesia

CV: peripheral edema, cellulitis, vasculitis, hypotension, angina, tachycardia, bradycardia, phlebitis, thrombophlebitis, cardiac arrest, heart failure, hemorrhage, ventricular asystole, pericardial effusion, sinus arrest

EENT: abnormal vision, nonreactive pupils, photophobia, retinopathy, eye pain, conjunctivitis, dry or watery eyes, hearing loss, tinnitus, ear pain, epistaxis, pharyngitis, rhinitis

GI: nausea, vomiting, diarrhea, constipation, dyspepsia, abdominal pain, ileus, flatulence, stomatitis, glossitis, anorexia

GU: amenorrhea, breast lump, erectile dysfunction, decreased libido, renal calculi, renal dysfunction, renal insufficiency, renal failure

Hematologic: ecchymosis, anemia, hemolytic anemia, agranulocytosis, aplastic anemia, leukopenia, thrombocytopenia

Metabolic: hyperuricemia, hypercalcemia, hyponatremia

Musculoskeletal: myalgia, joint pain

Respiratory: cough, dyspnea, respiratory tract infection, pulmonary embolism

Skin: rash, eczema, petechiae, dry skin, pruritus, skin disorder, furunculosis, acne, alopecia, diaphoresis, photosensitivity

Other: unusual taste, gingivitis, fever, chills, pain, facial edema, lymphadenopathy, herpes simplex or herpes zoster infection, flulike symptoms, viral or bacterial infection, allergic reaction, sepsis, neoplasm


Drug-drug. Allopurinol: hypersensitiv-ity vasculitis

Carmustine, cyclophosphamide, etoposide: potentially fatal acute pulmonary edema and hypotension

Fludarabine: severe or fatal pulmonary toxicity.

Vidarabine: increased risk and severity of adverse reactions

Drug-diagnostic tests. Calcium, liver

function tests, serum uric acid: increased values

Granulocytes, platelets, sodium, white blood cells: decreased levels

Patient monitoring

Monitor CBC (including platelet count). Watch for evidence of blood dyscrasias.

• Assess kidney and liver function tests. Stay alert for evidence of organ dysfunction.

• Monitor temperature. Watch for signs and symptoms of bacterial and viral infection.

• Closely monitor vital signs and ECG, particularly for life-threatening arrhythmias, heart failure, and pulmonary edema.

Patient teaching

Tell patient drug lowers resistance to infection. Instruct him to avoid crowds and to immediately report fever, cough, sore throat, and other infection symptoms.

• Advise patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids.

• Instruct female patient of childbearing age to avoid pregnancy during drug therapy and to seek medical advice before becoming pregnant.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


Nipent® Oncology An antimetabolic anticancer agent
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


An ADENOSINE DEAMINASE INHIBITOR anticancer drug. A brand name is Nipent.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
Standard treatment for HCL with 2-CDA or pentostatin can achieve long-term remission and excellent response that may last for several years [11].
A phase I/II randomized study was carried out on patients who underwent hematopoietic stem cell transplantation treated with pentostatin, a specific inhibitor of ADA.
In addition, studies using immunosuppressant regimens along with the immunotoxins also showed some benefit.[sup][3],[24],[25] Other regimens, including a lymphocyte-depleting regimen, which consists of pentostatin and cyclophosphamide, were also found promising in delaying the stimulation of neutralizing anti-immunotoxin antibodies, thus allowing repetitive immunotoxin treatments for patients with solid tumors.[sup][25] Pentostatin and cyclophosphamide selectively suppress the effect of T- and B-cells while largely sparing myeloid cells.[sup][26]
Except for high-dose corticosteroids as common therapy, mammalian target of rapamycin (mTOR) inhibitors sirolimus and pentostatin, Rituximab, and mycophenolate mofetil (MMF) have also been successfully applied in some patients [10].
The largest clinical trial of B-PLL included only 14 patients treated with pentostatin, and all other studies are limited to case reports or series with lesser than 10 patients [5].
Combination chemoimmunotherapy with pentostatin, cyclophosphamide, and rituximab shows significant clinical activity with low accompanying toxicity in previously untreated B chronic lymphocytic leukemia.
The second search used the terms 'Cyclosporine' or 'Clofazimine' or 'Steroids' or 'Hydroxychloroquine' or 'Methotrexate' or 'Mycophenolate mofetil' or 'Eicosapentaenoic acid' or 'Pentostatin' or 'Rituximab' or 'Sirolimus' or 'Tacrolimus' or 'Thalidomide' or 'Budesonide' or 'Extracorporeal' or 'Platelet' or 'Azathioprine' and 'Graft versus host disease' and 'Oral cavity'.
The initial therapy typically consists of single-agent purine analogues such as pentostatin or cladribine, which yield durable responses in most patients.
Catovsky, "Long-term results for pentostatin and cladribine treatment of hairy cell leukemia," Leukemia and Lymphoma, vol.
29 November 2011 - US biopharmaceutical firm OncoVista Innovative Therapies Inc (OTCBB:OVIT) said on Monday it had mandated consulting and clinical research organisation Oncology Therapeutic Development (OTD) to launch a Phase Ib clinical study of Cordycepin related to Pentostatin to treat terminal deoxynucleotidyl transferase (TdT)-positive refractory leukemia.
First-line therapy is with one of the cytotoxic agents, either cladribine or pentostatin. Splenectomy is another effective option, with results that last up to 10 years in 50% of cases.