A chemotherapy for hairy cell leukaemia
Pentostatin
A chemotherapy used to treat hairy cell leukaemia, given by injection into a vein.
What is Pentostatin?
Pentostatin is a specialist chemotherapy used to treat hairy cell leukaemia, a rare blood cancer. It is given by injection into a vein. The most important safety concern is that it strongly weakens the immune system, leaving people prone to serious infections that need watching for and treating promptly. It can also affect the kidneys, liver and blood counts, so these are monitored, and drinking plenty of fluids is advised. It is given by a specialist cancer team.
Education and reference only. This is a plain-language guide to Pentostatin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Pentostatin is a chemotherapy medicine used to treat hairy cell leukaemia, a slow-growing cancer of a type of white blood cell that gets its name from the hair-like surface of the cancer cells. It is one of the effective treatments for this condition and can lead to long periods without disease. It is given as an injection into a vein, in cycles, by a specialist cancer team. Because it strongly suppresses the immune system, it is used carefully with close monitoring for infections and other side effects.
How it works
Pentostatin blocks an enzyme that lymphocytes, a kind of white blood cell, rely on. When this enzyme is blocked, harmful substances build up inside these cells and kill them, including the abnormal cells of hairy cell leukaemia. This is very effective against the cancer, but because it acts on lymphocytes, which are central to the immune system, it also lowers the body's defences and leaves people at higher risk of infections. By clearing the leukaemia cells, it can bring the disease under control for a long time.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist chemotherapy used in the UK to treat hairy cell leukaemia, given into a vein.
Practical use
How to take Pentostatin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given as an injection into a vein by a specialist cancer team, in cycles.
- Report any fever, chills, sore throat or feeling unwell urgently, as infections can be serious.
- Drink plenty of fluids as advised to help protect your kidneys during treatment.
- Keep all appointments for blood tests and kidney and liver checks.
- Avoid live vaccines and tell any healthcare professional you are having this treatment.
Weighing it up
Advantages & disadvantages of Pentostatin
Advantages
- Very effective against hairy cell leukaemia and can give long periods without disease.
- Works in a targeted way against the white blood cells the cancer comes from.
- Given as part of specialist care with close monitoring.
Disadvantages
- Strongly weakens the immune system, raising the risk of serious infections.
- Can affect the kidneys, liver and blood counts, needing regular monitoring.
- Must be given in hospital by a specialist team, with careful follow-up.
Practical use
Good to know
The most important thing to understand about pentostatin is that it strongly weakens the immune system, often for a long time, so people are much more prone to serious infections; any fever, chills, sore throat or feeling unwell should be reported urgently, and the team may give protective medicines and advice on avoiding infection. It can also affect the kidneys and liver and lower blood counts, so blood tests and kidney and liver checks are done regularly, and drinking plenty of fluids is usually advised to help protect the kidneys. Nausea is common and can be managed with anti-sickness medicines. Live vaccines are avoided because the immune system is weakened. It is given only by a specialist cancer team experienced in its use, who balance its strong benefit against these risks.
Who should not take it / use with caution
- People who have had a serious allergic reaction to pentostatin should not be given it.
- It is generally avoided in pregnancy and while breastfeeding because of the risk of harm.
- It is used with great caution, or avoided, in people with significant kidney problems or active serious infection.
- It should only be used under a specialist cancer team experienced in its use.
Monitoring
- Regular blood tests to watch blood counts and immune cells.
- Checking kidney and liver function during treatment.
- Watching closely for signs of infection, given the weakened immune system.
Side effects
- A weakened immune system with a higher risk of infections.
- Nausea, vomiting or tiredness.
- Effects on the kidneys or liver, shown by blood tests.
- Low blood counts, leading to infections, bleeding or anaemia.
Key interactions
- It must not be combined with certain other chemotherapy medicines because of the risk of serious lung or other toxicity, so the team plans treatment carefully.
- Live vaccines are avoided during treatment because the immune system is weakened.
- Other medicines affecting the kidneys, liver or bone marrow may add to its effects, so tell your team everything you take.
Available as: A powder made up into a solution given as an injection into a vein.
Answers
Pentostatin: frequently asked questions
What is pentostatin used for?
It is a chemotherapy used to treat hairy cell leukaemia, a rare slow-growing blood cancer, and can give long periods without disease.
Why am I more likely to get infections?
Pentostatin strongly weakens the immune system, often for a long time, so report any fever, chills, sore throat or feeling unwell urgently.
Why do I need to drink plenty of fluids?
It can affect the kidneys, so drinking plenty of fluids helps protect them; your team will also check your kidney function with blood tests.
How is it given?
It is given as an injection into a vein, in cycles, by a specialist cancer team experienced in its use.
Can I have my usual vaccinations?
Live vaccines are avoided during treatment because your immune system is weakened; always check with your team before having any vaccine.
The wider class
About Cytotoxic chemotherapy (hairy cell leukaemia)
Pentostatin belongs to the cytotoxic chemotherapy (hairy cell leukaemia) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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