title: Bendamustine in heavily pre-treated patients with relapsed or refractory multiple myeloma.
abstract: OBJECTIVE
  Treatment options for patients with relapsed and refractory multiple myeloma have improved since the introduction of immune-modulating agents such as lenalidomide and thalidomide. However, almost all patients relapse and suffer from an increasing amount of adverse events due to multiple lines of therapy that eventually lead to a reduced quality of life.
  
  
  METHODS
  In this bicentric retrospective analysis, 58 patients who had been treated with either bendamustine monotherapy (62 % of the patients) or combined steroid therapy were included. Further inclusion criteria were at least relapsed disease. Patients had previously been treated with a mean of four lines of therapy (range 1-10). They received a median of three cycles of treatment. Dosage varied from 60 to 300 mg/m(2) (median 120 mg/m(2)) and was administered intravenously on day 1 and 2 of a 28-day cycle.
  
  
  RESULTS
  Observed toxicity was mild and most commonly led to hematological side effects such as thrombopenia and anemia. Response rates were as follows: no complete response, 20 % partial response, 39 % minimal response, 27 % stable disease and 14 % progressive disease. Median overall survival (OS) was 17 months. Median event-free survival was 7 months. Patients who had not received a concomitant steroid had a median OS of 17 months compared to 13 months median OS for patients who had received a concomitant steroid.
  
  
  CONCLUSIONS
  Bendamustine monotherapy is an effective treatment option for heavily pre-treated myeloma patients due to its favorable response rate and mild toxicity.
authors.affiliation: Department of Internal Medicine II, University Hospital Bonn, Bonn, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Stöhr
authors.affiliation: Department of Internal Medicine III, Center for Integrated Oncology (CIO), University Hospital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany. Carsten.Schmeel@ukb.uni-bonn.de.|Department of Radiology, University Hospital Bonn, Bonn, Germany. Carsten.Schmeel@ukb.uni-bonn.de.
authors.forename: Frederic Carsten
authors.initials: FC
authors.lastname: Schmeel
authors.affiliation: Department of Internal Medicine III, Center for Integrated Oncology (CIO), University Hospital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany.|Department of Radiology, University Hospital Bonn, Bonn, Germany.
authors.forename: Leonard Christopher
authors.initials: LC
authors.lastname: Schmeel
authors.affiliation: Department of Internal Medicine III, Clinicum Chemnitz, Chemnitz, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Hänel
authors.affiliation: Department of Internal Medicine III, Center for Integrated Oncology (CIO), University Hospital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany.
authors.forename: Ingo G H
authors.initials: IG
authors.lastname: Schmidt-Wolf
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D000069461:Bendamustine Hydrochloride / Q000627:therapeutic use*; D019008:Drug Resistance, Neoplasm / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate
chemical_list: D018906:Antineoplastic Agents, Alkylating; D000069461:Bendamustine Hydrochloride
keywords: Bendamustine; Dexamethasone; Myeloma; Treatment