Abstract
Background: Bendamustine (Ben) and combinations of Ben/rituximab(R) therapies have shown high efficacy in relapsed/refractory indolent B-cell non-Hodgkin lymphoma (NHL) and mantle cell lymphoma (MCL). No data exist about Ben retreatment after relapse, concerning efficacy and toxicity in these patients (pts) population.Patients and methods: Six pts (3 with follicular lymphoma, 1 lymphoplasmacytic lymphoma, 2 MCL) who had previously successfully been treated with first Ben and maintained its efficacy for over 6 months were retreated with Ben between December 2010 and November 2013. The median age was 72 years (61-75) and the ratio of gender was 2 males and 4 females. Pts received Ben at 90-120mg/m2 on day 1 and 2 in a 21-28 days cycle for up to 6 cycles. R (375mg/m2) was added on day 1 in 5 pts. Prophylactic acyclovir and trimethoprim-sulfamethoxazole (ST) were used. Granulocyte colony-stimulating factor (G-CSF) was administered in case of severe neutropenia. The observation duration was 30 months (18-33) from the first treatment and 6 months (2-11) from retreatment.Results: The number of previous regimens was 2 (1-5). An overall response rate of 83.3% (5 in 6 pts) (33.3% complete response rate (CR) and 50% partial response) was observed by 5 cycles (2-6) of Ben. Those 5 patients previously obtained CR by the first Ben. Another 1 pt who had previously obtained stable disease (SD) by the first Ben again got SD by retreatment of Ben. Response duration was 6 months (4-10). Grade 3 or 4 reversible hematologic toxicities were observed. Severe non-hematologic adverse events were not observed. Although cytomegalovirus (CMV) antigenemia was observed in 3 pts, the treatment of CMV was not required.Conclusion: Our data suggest high activity and good tolerance of Ben retreatment (and R) in pts with relapsed/refractory lymphoma despite previous Ben treatment. In view of this, prospective studies should be considered to establish efficacy and safety of Ben retreatment.
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