Pentostatin (Nipent)

General information

Class/mechanism: Purine (adenosine) analog, inhibitor of adenosine deaminase (ADA), causes elevated intracellular levels of dATP, and inhibits ribonucleotide reductase, which interferes with DNA synthesis. Pentostatin can also inhibit RNA synthesis and has been observed to cause DNA damage. ADA enzymatic activity is greater in T-cell malignancies compared to B-cell malignancies. Exact mechanism of action in hairy cell leukemia is not fully understood.
Route: IV
Extravasation: neutral

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is used

• Chronic lymphocytic leukemia
• Follicular lymphoma
• Hairy cell leukemia
• Marginal zone lymphoma
• T-cell prolymphocytic leukemia
• Waldenström macroglobulinemia

Diseases for which it was used

• B-cell acute lymphoblastic leukemia

Patient drug information

• Pentostatin (Nipent) patient drug information (Chemocare)
• Pentostatin (Nipent) patient drug information (UpToDate)

History of changes in FDA indication

• 1991-10-11: Initial approval for treatment for adult patients with alpha-interferon-refractory hairy cell leukemia. (Based on SWOG 8691)

Also known as

• Generic names: 2'-deoxycoformycin, dCF
• Brand name: Nipent