title: Efficacy and safety of bendamustine for the treatment of patients with recurring Hodgkin lymphoma.
abstract: The management of patients with Hodgkin lymphoma (HL) recurring after stem cell transplantation (SCT) and multiply relapsed disease remains challenging. We report on 41 such patients who received bendamustine hydrochloride, a bifunctional mechlorethamine derivative mechanistically unrelated to traditional alkylators, after a median of four prior chemotherapy lines, including SCT in 85% of cases. Bendamustine was given at doses of 90-120 mg/m(2) every 21 or 28 d. At first assessment (2-4 cycles), the overall response rate (ORR) was 78% with 12 (29%) complete (CR) and 20 (49%) partial responses (PR). Upon treatment prolongation to 6-8 courses, 40% of PRs progressed, yielding a final ORR of 58% with 31% of CRs. Eight patients (two CRs, six PRs) were subsequently allotransplanted. Median progression-free and overall survival exceeded 11 and 21 months respectively; complete responders displayed a median disease-free survival above 9 months with a relapse rate of only 30%. Outcomes were independent of disease chemosensitivity, previous transplant and bendamustine dose-intensity. No life-threatening or unexpected adverse events occurred. Within the limits of a retrospective analysis and schedule heterogeneity, these results appear very encouraging and prompt prospective trials to confirm bendamustine as a valuable option in the palliative setting and in cytoreductive strategies before allotransplantation.
authors.affiliation: Haematology-Oncology and Stem Cell Transplantation Unit, Department of Haematology, Fondazione G. Pascale, IRCCS, Naples, Italy. g.corazzelli@istitutotumori.na.it
authors.forename: Gaetano
authors.initials: G
authors.lastname: Corazzelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Angrilli
authors.forename: Alfonso
authors.initials: A
authors.lastname: D'Arco
authors.forename: Felicetto
authors.initials: F
authors.lastname: Ferrara
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Musto
authors.forename: Attilio
authors.initials: A
authors.lastname: Guarini
authors.forename: Maria Christina
authors.initials: MC
authors.lastname: Cox
authors.forename: Caterina
authors.initials: C
authors.lastname: Stelitano
authors.forename: Sergio
authors.initials: S
authors.lastname: Storti
authors.forename: Emilio
authors.initials: E
authors.lastname: Iannitto
authors.forename: Simona
authors.initials: S
authors.lastname: Falorio
authors.forename: Catello
authors.initials: C
authors.lastname: Califano
authors.forename: Alfonso
authors.initials: A
authors.lastname: Amore
authors.forename: Manuela
authors.initials: M
authors.lastname: Arcamone
authors.forename: Rosaria
authors.initials: R
authors.lastname: De Filippi
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069461:Bendamustine Hydrochloride; D059447:Cell Cycle Checkpoints / Q000187:drug effects; D003131:Combined Modality Therapy; D004260:DNA Repair / Q000187:drug effects; D018572:Disease-Free Survival; D004341:Drug Evaluation; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009588:Nitrogen Mustard Compounds / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D056687:Off-Label Use; D012008:Recurrence; D012189:Retrospective Studies; D016879:Salvage Therapy; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D009588:Nitrogen Mustard Compounds; D000069461:Bendamustine Hydrochloride