title: Bendamustine and rituximab combination is safe and effective as salvage regimen in Waldenström macroglobulinemia.
abstract: According to the European Society for Medical Oncology and National Comprehensive Cancer Network guidelines on Waldenström macroglobulinemia, bendamustine (B) may be considered a suitable therapeutic option. To address the role of B in combination with rituximab (BR), we analyzed the outcome of 71 patients with relapsed/refractory disease, median age 72 years, treated with R 375 mg/m(2) day 1 and B days 1 and 2 (dosage ranging from 50 to 90 mg/m(2)). Patients had previously received a median number of 2 lines of treatment (range 1-5). Overall and major response rates were 80.2% and 74.6%. Major toxicity was grade 3/4 neutropenia occurring in 13% of courses. There was no significant association between baseline features or patients' characteristics and response achievement. Median progression-free survival was not reached after a median follow-up of 19 months (range 3-54). None of the patients developed aggressive lymphoma or secondary myelodysplastic syndrome/acute myeloid leukemia. BR was found to be an active and well-tolerated salvage regimen leading to rapid disease control.
authors: a Department of Hematology , Niguarda Ca' Granda Hospital , Milano , Italy.
authors: Alessandra
authors: A
authors: Tedeschi
authors: a Department of Hematology , Niguarda Ca' Granda Hospital , Milano , Italy.
authors: Paola
authors: P
authors: Picardi
authors: b Department of Hematology , University of Torino , Torino , Italy.
authors: Simone
authors: S
authors: Ferrero
authors: c Department of Hematology , AO Città della Salute e della Scienza di Torino , San Giovanni Battista, Torino , Italy.
authors: Giulia
authors: G
authors: Benevolo
authors: d Division of Hematology, Department of Translational Medicine , Amedeo Avogadro University of Eastern Piedmont , Novara , Italy.
authors: Gloria
authors: G
authors: Margiotta Casaluci
authors: e Department of Hematology , IRCCS Policlinico San Matteo , Pavia , Italy.
authors: Marzia
authors: M
authors: Varettoni
authors: f Department of Clinical and Experimental Medicine , University of Pisa , Pisa , Italy.
authors: Claudia
authors: C
authors: Baratè
authors: g Department of Hematology , AO Spedali Civili , Brescia , Italy.
authors: Marina
authors: M
authors: Motta
authors: h Department of Hematology , AOU Ospedali Riuniti , Ancona , Italy.
authors: Guido
authors: G
authors: Gini
authors: i Department of Hematology , IRCCS Ospedale Maggiore Policlinico, Università degli Studi di Milano , Milano , Italy.
authors: Maria Cecilia
authors: MC
authors: Goldaniga
authors: j Department of Cell Therapy and Hematology , Ospedale San Bortolo , Vicenza , Italy.
authors: Carlo
authors: C
authors: Visco
authors: k Department of Hematology , AO Universitaria S. Maria Misericordia , Udine , Italy.
authors: Francesco
authors: F
authors: Zaja
authors: l Department of Oncology and Hematology , General Hospital , Nocera Inferiore , Italy.
authors: Valeria
authors: V
authors: Belsito Petrizi
authors: m Department of Internal Medicine , Valduce Hospital , Como , Italy.
authors: Erika
authors: E
authors: Ravelli
authors: n Department of Hematology , AO di Cosenza , Cosenza , Italy.
authors: Massimo
authors: M
authors: Gentile
authors: b Department of Hematology , University of Torino , Torino , Italy.
authors: Marina Aurora
authors: MA
authors: Urbano
authors: d Division of Hematology, Department of Translational Medicine , Amedeo Avogadro University of Eastern Piedmont , Novara , Italy.
authors: Silvia
authors: S
authors: Franceschetti
authors: b Department of Hematology , University of Torino , Torino , Italy.
authors: Paola
authors: P
authors: Ghione
authors: c Department of Hematology , AO Città della Salute e della Scienza di Torino , San Giovanni Battista, Torino , Italy.
authors: Lorella
authors: L
authors: Orsucci
authors: a Department of Hematology , Niguarda Ca' Granda Hospital , Milano , Italy.
authors: Anna Maria
authors: AM
authors: Frustaci
authors: d Division of Hematology, Department of Translational Medicine , Amedeo Avogadro University of Eastern Piedmont , Novara , Italy.
authors: Gianluca
authors: G
authors: Gaidano
authors: c Department of Hematology , AO Città della Salute e della Scienza di Torino , San Giovanni Battista, Torino , Italy.
authors: Umberto
authors: U
authors: Vitolo
authors: a Department of Hematology , Niguarda Ca' Granda Hospital , Milano , Italy.
authors: Enrica
authors: E
authors: Morra
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000069461:Bendamustine Hydrochloride / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D000069283:Rituximab / Q000008:administration & dosage; D016879:Salvage Therapy; D016896:Treatment Outcome; D008258:Waldenstrom Macroglobulinemia / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality
chemical_list: D000069283:Rituximab; D000069461:Bendamustine Hydrochloride
keywords: Bendamustine; Waldenström macroglobulinemia; refractory; relapsed; rituximab; salvage