Abstract
Prolonged lymphocytopenia after bendamustine therapy in patients with relapsed or refractory indolent B-cell and mantle cell lymphoma
Highlights
Bendamustine with or without rituximab has demonstrated remarkable efficacy in patients with relapsed or refractory indolent B-cell non-Hodgkin lymphoma (B-NHL) and mantle cell lymphoma (MCL),[1,2,3] previous reports showed that the incidence of lymphocytopenia was higher in patients receiving bendamustine with or without rituximab than in those receiving other conventional cytotoxic chemotherapies such as R-CHOP regimen,[4,5,6,7] which triggers opportunistic infections including cytomegalovirus (CMV) reactivation, hepatitis B virus reactivation, varicella zoster virus (VZV) infections and Pneumocystis jirovecii pneumonia (PCP).[8,9,10,11,12]
Recovery of lymphocyte and CD4-positive T-cell counts to those at the start of treatment was observed in patients who did not receive the treatment at 7–9 months after the completion of bendamustine with or without rituximab, and median lymphocyte and CD4-positive T-cell counts were
No statistically significant differences were detected between lymphocytopenia and the incidence of infectious events in this study, mainly because of the small number of patients, all infectious events occurred within 9 months after the completion of bendamustine in patients who received no treatment after bendamustine during follow-up
Summary
Blood Cancer Journal (2015) 5, e362; doi:10.1038/bcj.2015.86; published online 23 October 2015. We analyzed their peripheral blood lymphocytes and CD4-positive T-cell counts before, during and after bendamustine treatment, the details of infectious events and their correlations. Before starting bendamustine treatment (that is, at baseline), median lymphocyte and CD4-positive T-cell counts were 1025/μl (range: 270–3420/μl) and 282/μl (range: 83–645/μl), respectively. During the period between the completion of bendamustine and starting the treatment (that is, during observation), the median lymphocyte and CD4-positive T-cell count nadirs were 365/μl (range: 20–1310/μl) and 93/μl (range: 7–178/μl), respectively. Recovery of lymphocyte and CD4-positive T-cell counts to those at the start of treatment was observed in patients who did not receive the treatment at 7–9 months after the completion of bendamustine with or without rituximab, and median lymphocyte and CD4-positive T-cell counts were
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