Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 30;11(4):249.
doi: 10.3390/jpm11040249.

Real Life Use of Bendamustine in Elderly Patients with Lymphoid Neoplasia

Irene Dogliotti  1 , Simone Ragaini  2 , Francesco Vassallo  3 , Elia Boccellato  2 , Gabriele De Luca  2 , Francesca Perutelli  2 , Carola Boccomini  3 , Michele Clerico  2 , Barbara Botto  3 , Daniele Grimaldi  2 , Lorella Orsucci  3 , Simone Ferrero  2 , Candida Vitale  2 , Dario Ferrero  2 , Marta Coscia  2 , Federica Cavallo  2
Affiliations

Real Life Use of Bendamustine in Elderly Patients with Lymphoid Neoplasia

Irene Dogliotti et al. J Pers Med. .

Abstract

Background: Bendamustine is a cytotoxic alkylating drug with a broad range of indications as a single agent or in combination therapy in lymphoid neoplasia patients. However, its tolerability in elderly patients is still debated.

Methods: An observational, retrospective study was carried out; patients with chronic lymphocytic leukemia (CLL) or lymphoma, aged ≥ 65 years old, treated with bendamustine-based regimens in first or subsequent lines between 2010 and 2020 were considered eligible.

Results: Overall, 179 patients aged ≥ 65 years were enrolled, 53% between 71 and 79 years old. Cumulative Illness Rating Scale (CIRS) comorbidity score was ≥6 in 54% patients. Overall survival (OS) at 12 months was 95% (95% confidence interval [CI]: 90-97%); after a median follow up of 50 months, median OS was 84 months. The overall response rate was 87%, with 56% complete responses; the median time to progression (TTP) was 61 months. The baseline factors affecting OS by multivariable analysis were sex, histological diagnosis, renal function, and planned bendamustine dose, while only type of lymphoma and bendamustine dose impacted on TTP. Main adverse events were neutropenia (grade ≥ 3: 43%) and infections (any grade: 36%), with 17% of patients requiring hospital admission.

Conclusions: The responses to bendamustine, as well as survival, are relevant even in advanced age patients, with a manageable incidence of acute toxicity.

Keywords: bendamustine; chronic lymphocytic leukemia; efficacy; elderly; lymphoma; safety.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Response to bendamustine treatment. Best response obtained after receiving at least 1 bendamustine-containing course.
Figure 2
Figure 2
Univariate analysis for OS. panel (A): median OS after bendamustine-based treatment initiation, overall series; panel (B): OS according to different age classes; panel (C): OS stratified accoding to initial diagnosis; panel (D): OS divided by patients’ sex; panel (E): OS according to CIRS score; panel (F): according to BCC at baseline; panel (G): effect of bendamustine dose received on OS; panel (H): OS stratified according to line of therapy at bendamustine treatment.
Figure 3
Figure 3
Multivariable analysis for OS. Forest plot describing multivariable analysis results for OS.
Figure 4
Figure 4
Univariate analysis for TTP. Panel (A): median TTP after bendamustine-based treatment initiation, overall series; panel (B): TTP according to different age classes; panel (C): TTP stratified by initial histological diagnosis; panel (D): TTP according to CIRS score at bendamustine administration; panel (E): effect of bendamustine dose received on TTP; panel (F): TTP stratified according to line of therapy at bendamustine treatment.
Figure 5
Figure 5
Multivariable analysis for TTP. Forest plot describing multivariable analysis results for TTP.
See this image and copyright information in PMC

References

    1. Darwish M., Bond M., Hellriegel E., Robertson P.J., Chovan J.P. Pharmacokinetic and pharmacodynamic profile of bendamustine and its metabolites. Cancer Chemother. Pharmacol. 2015;75:1143–1154. doi: 10.1007/s00280-015-2727-6. - DOI - PMC - PubMed
    1. Cheson B.D., Brugger W., Damaj G., Dreyling M., Kahl B., Kimby E., Ogura M., Weidmann E., Wendtner C.-M., Zinzani P.L. Optimal use of bendamustine in hematologic disorders: Treatment recommendations from an international consensus panel—An update. Leuk. Lymphoma. 2016;57:766–782. doi: 10.3109/10428194.2015.1099647. - DOI - PMC - PubMed
    1. Eichhorst B., Ghia P. EHA Endorsement of ESMO Clinical Practice Guidelines for Diagnosis, Treatment, and Follow-up of Chronic Lymphocytic Leukemia. HemaSphere. 2021;5:e520. doi: 10.1097/HS9.0000000000000520. - DOI - PMC - PubMed
    1. Kater A.P., Wu J.Q., Kipps T., Eichhorst B., Hillmen P., D’Rozario J., Assouline S., Owen C., Robak T., de la Serna J., et al. Venetoclax Plus Rituximab in Relapsed Chronic Lymphocytic Leukemia: 4-Year Results and Evaluation of Impact of Genomic Complexity and Gene Mutations From the MURANO Phase III Study. J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol. 2020;38:4042–4054. doi: 10.1200/JCO.20.00948. - DOI - PMC - PubMed
    1. Woyach J.A., Ruppert A.S., Heerema N.A., Zhao W., Booth A.M., Ding W., Bartlett N.L., Brander D.M., Barr P.M., Rogers K.A., et al. Ibrutinib Regimens versus Chemoimmunotherapy in Older Patients with Untreated CLL. N. Engl. J. Med. 2018;379:2517–2528. doi: 10.1056/NEJMoa1812836. - DOI - PMC - PubMed