Bendamustine with or without rituximab for the treatment of heavily pretreated non-Hodgkin’s lymphoma patients

Abstract

Bendamustine is an alkylating agent with a nitrogen mustard group and a purine-like benzimidazole group. The aim of this study was to collect all the Italian experiences with this drug in order to evaluate the results in term of response to therapy and toxicities. We analyzed lymphoma patients treated in 24 Italian haematological centres with bendamustine alone or in combination with anti-CD20 antibody. One hundred seventy-five relapsed or refractory lymphoma patients were enrolled. The median age was 69 years (range 26-87). Seventy-nine patients were relapsed, 35 were refractory and 61 presented a progressive disease after partial response. The diagnoses were 60 indolent non-follicular lymphomas, 34 diffuse large B-cell lymphomas, 48 follicular lymphomas, 30 mantle cell lymphomas and three peripheral T-cell lymphomas. All patients were evaluable for response: 52 (29%) with complete remission, 72 (43%) with partial response with an overall response rate of 71%, and 51 non-responders. With a median observation period of 10 months (1-43), 70% of patients are alive. In summary, this retrospective study shows that treatment with bendamustine alone or in combination with rituximab is a safe and effective regimen in a subset of multi-resistant patients.

18F-FDG PET for Measurement of Response and Prediction of Outcome to Relapsed or Refractory Mantle Cell Lymphoma Therapy with Bendamustine–Rituximab

“…Combination BR has demonstrated efficacy with manageable tolerability as a first-line therapy for mixed patient populations with indolent NHL or MCL (3,13) and for relapsed or refractory disease (2,14,15).…”

Idiotypic Vaccination: Still a Unique form of Cancer Immunotherapy for Follicular Lymphoma after 20 Years

“…Despite the set-backs, idiotypic vaccination remains an extremely attractive approach (Inoges et al 2009) to possibly reduce relapse of some types of lymphoma. Since every failed randomized clinical trial costed hundreds of million of dollars, careful study design is necessary, including the selection of the most suitable pre-vaccine chemotherapy regimen (Siddhartha, Vijay 2009, Zinzani et al 2000, Rigacci et al 2012.…”

Bendamustine as Monotherapy and in Combination Regimens for the Treatment of Chronic Lymphocytic Leukemia and Non-Hodgkin Lymphoma: A Retrospective Analysis

“…Routine use of granulocyte-stimulating factors or anti-infective prophylaxis is not indicated unless it is in patients with recurrent or serious infective complications in their medical history. However, it should be remembered that myelosuppression is the major toxicity associated with bendamustine [20,36]. Patients with relapsed/refractory CLL and NHL, especially after purine analogue therapy, are much more susceptible to myelosuppressive complications than with first-line therapy.…”

“…In our study, grade III/IV infections occurred in 10.8% of patients, while 2 patients died due to infections during therapy and 6 died during follow-up. The development of infections during bendamustine therapy has been reported before, including deaths due to sepsis and pneumonia [20,36]. Special attention should be paid to preventing infections since they are the main reason of patient morbidity and mortality in response to bendamustine.…”