Purine analogues are attractive therapeutic candidates for CTCL because they are potent inhibitors of the enzyme adenosine deaminase, which preferentially accumulates in lymphoid cells, such that these drugs are selectively lymphocytotoxic independently of cell division. Although efficacy in CTCL is moderate, most of these patients were heavily pretreated and relatively chemoresistant. Patients with Sezary syndrome appear to respond better than those with late stages of mycosis fungoides. Purine analogues are appropriate as monotherapy, especially in Sezary syndrome, but response duration may be short. Comparative trials with other single-agent regimens in Sezary syndrome are required.
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