title: Bendamustine associated immune suppression and infections during therapy of hematological malignancies.
abstract: Bendamustine is being increasingly used in patients with indolent non-Hodgkin lymphoma, mantle cell lymphoma and chronic lymphocytic leukemia. This review summarizes available evidence regarding the effects of bendamustine on the immune system, examines its role in consequent infections as reported in randomized controlled trials, prospective observational investigations, retrospective studies and individual published case reports. Myelosuppression including lymphopenia occurs relatively frequently after therapy with bendamustine. It is mostly CD4 + T cell counts that are suppressed, yet when given in combination with rituximab, both T cell and B cell depletion have been recorded. In addition, hypogammaglobulinemia after bendamustine therapy has also been reported. Variable infection rates have been documented and these include different bacterial, viral and fungal infections. Finally, we also consider issues relating to the use of prophylactic antibiotics in patients receiving the drug.
authors.affiliation: a Department of Medicine A , Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center , Petah-Tikva , Israel ;|b Sackler School of Medicine , Tel-Aviv , Israel ;
authors.forename: Anat
authors.initials: A
authors.lastname: Gafter-Gvili
authors.affiliation: c Department of Hematology , Hadassah University Hospital and Hebrew University Medical School , Ein Karem , Jerusalem , Israel.
authors.forename: Aaron
authors.initials: A
authors.lastname: Polliack
mesh_terms: D000361:Agammaglobulinemia / Q000209:etiology; D019072:Antibiotic Prophylaxis; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069461:Bendamustine Hydrochloride / Q000009:adverse effects* / Q000627:therapeutic use; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007107:Immune System / Q000187:drug effects; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007239:Infections / Q000188:drug therapy / Q000209:etiology*; D008231:Lymphopenia / Q000209:etiology
chemical_list: D018906:Antineoplastic Agents, Alkylating; D007166:Immunosuppressive Agents; D000069461:Bendamustine Hydrochloride
keywords: Bendamustine; chemo-therapy; hematological malignancies; immune suppression; infections