Bendamustine treatment of B-cell lymphoproliferative disorders: A single-institution experience.

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BlankBendamustine treatment of B-cell lymphoproliferative disorders: A

single-institution experience.

Sub-category: Lymphoma

Category: Lymphoma and Plasma Cell Disorders

Meeting: 2010 ASCO Annual Meeting

Citation: J Clin Oncol 28, 2010 (suppl; abstr e18542)

Abstract No: e18542

Author(s): J. L. Knoble, J. Densmore, M. E. ; University of Virginia

Health System, Charlottesville, VA; University of Virginia, Charlottesville, VA;

University of Virginia Medical Center, Charlottesville, VA

Abstract:

Background: Bendamustine ( has been an established treatment of

lymphoproliferative disorders (LPD) in Germany for over 30 years. The drug has

only recently gained FDA approval, however, and clinical experience with the

drug in the United States is limited. The unique drug structure, with both

alkylating and antimetabolite features, suggests a unique clinical activity

profile including alkylator-resistant LPD. We evaluated B response and toxicity

data and compared these outcomes with reported experience. Methods: A

retrospective chart review was conducted on patients who received B at our

institution for treatment of a LPD, both on or off clinical trials. 30 patients,

median age 68.5, received 1 to 7 cycles of therapy from 9/2004 through 7/2009;

17 patients received the drug on clinical trial. B was used as a single agent

(n=11) or in combination with rituximab ® (n=19). All patients were treated

previously, 28 with at least one prior R- containing regimen. Dosing ranged from

60 to 120 mg/m2 on days 1 and 2 of each 3 or 4 week cycle. Results: The overall

response rate (ORR) was 73%. Complete response (CR/CRu) was 37%, and partial

response (PR) was also 37%. Median progression-free survival (PFS) was 17

months. Toxicity was evaluated using the CTCAE v3.0 grading system. Nausea was

the most common reported toxicity (grade 1, n=8, grade 2, n=3) . Grade 1 skin

rash was reported in 3 patients. Grade 1 thrombocytopenia was reported in 7

patients, and 3 patients required dose reduction/delay due to grade 3 toxicity.

3 patients developed grade 1 neutropenia, and 1 had grade 3 toxicity. There were

no treatment-related deaths. Conclusions: B ± R responses correlated with

previously reported findings among several individual LPD subtypes, with the

exception of a poorer response in MCL patients. Our findings endorse significant

clinical activity including patients with relapsed/refractory disease, with an

acceptable toxicity profile.

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LPD subtype n ORR (%) CR (%) PR (%) Median PFS (mo.)

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Follicular 14 13 (93) 6 (43) 7 (50) 22

Mantle cell 6 3 (50) 0 3 (50) 3.5

CLL/SLL 8 6 (75) 5 (62.5) 1 (12.5) 21

Diffuse large B cell 2 0 0 0 NA

Totals 30 22 (73) 11 (37) 11 (37) 17

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