Purine nucleoside therapy of low-grade follicular lymphoma

Low-grade follicular lymphomas, follicular small cleaved and follicular mixed, generally follow an indolent but progressive course. Although available therapies induce responses, continuous relapse occurs. In investigating potential therapeutic regimens, researchers have sought regimens that will result in a postchemotherapy survival plateau rather than a pattern of continuous relapse. The newer, purine analogs, 2'-deoxycoformycin, fludarabine, and 2-chlorodeoxyadenosine have shown activity in the low-grade B-cell lymphomas, especially with the follicular histologic subtype. Response rates in studies of previously untreated patients approach 100%. The newer purine analogs are emerging as an important treatment approach for indolent B-cell lymphomas, but the impact on survival remains to be assessed.