Pentostatin is a pharmaceutical agent that belongs to the antimetabolites and is used in the treatment of hairy cell leukemia. Hairy cell leukemia is characterized by an abnormality of lymphocytes and is characterized by a decrease in white and red blood cells and anemia, among other symptoms.
What is pentostatin?
Pentostatin is used in the treatment of hairy cell leukemia. This is characterized by, among other things, a reduction in white and red blood cells, as well as anemia. Pentostatin is a drug with the chemical formula C11H16N4O4 that doctors use to treat hairy cell leukemia. Hairy cell leukemia owes its name to the hair-like appearance of certain lymphocytes when the disease is present. In the past, pentostatin was also used for other forms of leukemia, but it is now considered less suitable for this purpose because severe side effects occurred when combination drugs were used. In Germany and other countries, doctors therefore no longer use it in these areas and instead resort to other drugs and other forms of therapy. Pentostatin dissolves in water and methanol and can appear in drugs as the only active ingredient or in combination with other active ingredients.
Pharmacologic action
According to current knowledge, the effect of pentostatin is based on the inhibition of an enzyme in cancer tissue. An enzyme is a biomolecule composed of proteins that catalyzes, or accelerates, biochemical reactions within organisms. Enzymes are substrate-specific, in that an enzyme can only work with certain starting materials, and action-specific, in that they cannot perform arbitrary actions but, for example, can only sever a molecular chain rather than also bring it together, extend it, or otherwise react with it. Pentostatin inhibits the enzyme adenosine deaminase, which is essential for tumor metabolism and, more importantly, cell division. However, adenosine deaminase is also found in other, healthy cells; pentostatin, like many chemotherapeutic drugs, is therefore toxic to some extent. Because cancer cells divide particularly frequently, they are often more affected by the toxicity of such agents than other cells in the human body, and in some circumstances pentostatin may help to combat leukemia in this way.
Medical application and use
Pentostatin may be used in the treatment of hairy cell leukemia. Hairy cell leukemia affects the human lymphatic system, which is central to the immune system. For this reason, malignant hairy cell leukemia belongs to the so-called non-Hodgkin’s lymphomas, which in turn belong to the chronic leukemias. Three symptoms are particularly typical of hairy cell leukemia:
- Deficiency of the red blood pigment hemoglobin (anemia).
- Reduced number of white blood cells (leukocytes) in the blood, that is, leukopenia
- Reduced number of platelets (thrombocytes), that is, thrombocytopenia.
Through these three core symptoms, hairy cell leukemia can cause other symptoms such as increased susceptibility to infections, fatigue, dizziness and pallor. In addition, bleeding may take an unusually long time to dry up. Anemia, leukopenia, and thrombocytopenia in hairy cell leukemia may be due to dysfunction of the bone marrow, which is essentially involved in the synthesis of blood cells. Furthermore, individuals suffering from this disease often have an enlarged spleen and, less commonly, an enlarged liver. On average, the disease manifests after the age of 50 and is rare overall. The drug is usually taken by infusion. In addition to pentostatin, other purine analogues may be considered for the treatment of hairy cell leukemia.
Risks and side effects
Several side effects may occur when pentostatin is taken. They may, but need not, occur together and may also present in different combinations. In principle, physicians and patients must agree on a case-by-case basis whether the ratio of risks and benefits seems appropriate for the individual. Interactions with fludarabine, cyclophosphamide and vidarabine, among others, are known to medicine.It is also not recommended if the patient has a history of hypersensitivity to pentostatin. Especially during the first weeks of drug therapy with pentostatin, the active substance can also cause so-called myelosuppression. This is a complication that affects the patient’s bone marrow and is therefore also known as bone marrow inhibition or bone marrow depression. In healthy people, the bone marrow produces blood cells. As a result of the medication, this function may be subject to disruption. Other potential side effects of pentostatin include digestive system symptoms such as nausea and vomiting, as well as fatigue, [fever]], and increased susceptibility to infectious diseases due to immune system dysfunction, which can also worsen pre-existing infections. In addition, some patients show decreased white blood cell and platelet counts when taking pentostatin. To detect the many possible side effects early, if necessary, regular blood checks and other tests usually accompany treatment.
