title: Bendamustine in combination with rituximab for elderly patients with previously untreated B-cell chronic lymphocytic leukemia: A retrospective analysis of real-life practice in Italian hematology departments.
abstract: The front-line therapy for CLL young and fit patients is chemo-immunotherapy with fludarabine-cyclophosphamide-rituximab (FCR). FCR regimen results in a significant myelosuppression and high rates of early and late infections especially in elderly patients. German CLL study group compared FCR vs. bendamustine-rituximab (BR) in fit untreated patients. The response rates with BR or FCR were comparable, BR could be an alternative 1st-line treatment for elderly patients. Here we report retrospective data of 70 elderly (≥65 years) CLL patients from 12 Italian centers treated with BR as front-line therapy. The primary end points were overall response rate (complete remission/partial remission) and safety. Forty-seven males and 23 females, with a median age of 72 years, were included in the study. Eight patients were unfit for CIRS. The OR rate was 88.6% (31.4% CR and 57.2% PR). Progression free survival, treatment free survival and overall survival rates at 2-years were 79%, 90.3% and 89.6%, respectively. Only del17 was independent unfavorable parameter on the response rate and PFS. Our results indicate that BR front-line at standard dose provides a high response rate with a good safety profile, even if more than 50% of patients experienced a bendamustine dose reduction until 70 mg/m2.
authors: Catholic University of the Sacred Heart, A. Gemelli Policlinic, Rome, Italy. Electronic address: l.laurenti@rm.unicatt.it.
authors: Luca
authors: L
authors: Laurenti
authors: Catholic University of the Sacred Heart, A. Gemelli Policlinic, Rome, Italy.
authors: Idanna
authors: I
authors: Innocenti
authors: Catholic University of the Sacred Heart, A. Gemelli Policlinic, Rome, Italy.
authors: Francesco
authors: F
authors: Autore
authors: Haematology Unit, "G. Panico" Hospital, Tricase, Lecce, Italy.
authors: Barbara
authors: B
authors: Vannata
authors: International Center for Genetic Engineering & Biotechnology, Monterotondo Scalo, Italy.
authors: Dimitar G
authors: DG
authors: Efremov
authors: Careggi Hospital, Florence, Italy.
authors: Stefania
authors: S
authors: Ciolli
authors: Tor Vergata University, Rome, Italy.
authors: Giovanni
authors: G
authors: Del Poeta
authors: La Sapienza University, Umberto I Policlinic, Rome, Italy.
authors: Francesca Romana
authors: FR
authors: Mauro
authors: IRCCS Ca' Granda - Università degli Studi, Milan, Italy.
authors: Agostino
authors: A
authors: Cortelezzi
authors: San Giovanni Addolorata Hospital, Rome, Italy.
authors: Paola Anticoli
authors: PA
authors: Borza
authors: S. Chiara Hospital, Pisa, Italy.
authors: Francesco
authors: F
authors: Ghio
authors: University of Messina, Messina, Italy.
authors: Patrizia
authors: P
authors: Mondello
authors: A. Businco Hospital, Cagliari, Italy.
authors: Roberta
authors: R
authors: Murru
authors: Le Scotte Policlinic, Siena, Italy.
authors: Alessandro
authors: A
authors: Gozzetti
authors: Paolo Giaccone Policlinic, Palermo, Italy.
authors: Maria Rosa Lanza
authors: MR
authors: Cariccio
authors: Catholic University of the Sacred Heart, A. Gemelli Policlinic, Rome, Italy.
authors: Nicola
authors: N
authors: Piccirillo
authors: Careggi Hospital, Florence, Italy.
authors: Riccardo
authors: R
authors: Boncompagni
authors: Tor Vergata University, Rome, Italy.
authors: Maria
authors: M
authors: Cantonetti
authors: Tor Vergata University, Rome, Italy.
authors: Maria Ilaria Del
authors: MI
authors: Principe
authors: IRCCS Ca' Granda - Università degli Studi, Milan, Italy.
authors: Gianluigi
authors: G
authors: Reda
authors: San Giovanni Addolorata Hospital, Rome, Italy.
authors: Velia
authors: V
authors: Bongarzoni
authors: S. Chiara Hospital, Pisa, Italy.
authors: Giulia
authors: G
authors: Cervetti
authors: University of Messina, Messina, Italy.
authors: Vincenzo
authors: V
authors: Pitini
authors: La Sapienza University, Umberto I Policlinic, Rome, Italy.
authors: Robin
authors: R
authors: Foà
authors: Catholic University of the Sacred Heart, A. Gemelli Policlinic, Rome, Italy.
authors: Simona
authors: S
authors: Sica
authors: IRCCS Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy.
authors: Giovanni
authors: G
authors: D'Arena
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069461:Bendamustine Hydrochloride / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007558:Italy; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D012189:Retrospective Studies; D000069283:Rituximab / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000069283:Rituximab; D000069461:Bendamustine Hydrochloride
keywords: Bendamustine; CLL; Elderly patients; First-line treatment; Rituximab