title: Rituximab, bendamustine and lenalidomide in patients with aggressive B-cell lymphoma not eligible for anthracycline-based therapy or intensive salvage chemotherapy - SAKK 38/08.
abstract: An increasing number of older patients are suffering from aggressive lymphoma. Effective and more tolerable treatment regimens are urgently needed for this growing patient population. Patients with aggressive lymphoma not eligible for anthracycline-based first-line therapy or intensive salvage regimens were treated with the rituximab-bendamustine-lenalidomide (R-BL) regimen (rituximab 375 mg/m(2)  day 1, bendamustine 70 mg/m(2)  d 1, 2, lenalidomide 10 mg d 1-21) for six cycles every 4 weeks. Forty-one patients with a median age of 75 (range 40-94) years were enrolled: 33 patients had substantial co-morbidities. 13 patients were not eligible for anthracycline-based first-line chemotherapy, 28 patients had relapsed/refractory disease. The primary endpoint, overall response, was achieved by 25 (61%) patients (95% confidence interval 45-76%). Grade ≥ 3 toxicity comprised haematological (59%), skin (15%), constitutional (15%) and neurological (12%) events. 9 patients died during trial treatment: 5 from lymphoma progression, 2 from toxicity, 2 with sudden death. After a median follow-up of 25·9 (interquartile range 20·4-31·6) months, 13 patients were still alive. Median overall survival was 14·5 months. In conclusion, R-BL can be considered a treatment option for elderly patients with treatment naïve or relapsed/refractory aggressive lymphoma not eligible for standard aggressive regimens.
authors.affiliation: Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors.forename: Felicitas
authors.initials: F
authors.lastname: Hitz
authors.affiliation: IOSI (Istituto Oncologico della Svizzera Italiana), Bellinzona, Switzerland.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Zucca
authors.affiliation: Inselspital Bern, Bern, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Pabst
authors.affiliation: Kantonsspital Winterthur, Winterthur, Switzerland.
authors.forename: Natalie
authors.initials: N
authors.lastname: Fischer
authors.affiliation: University Hospital CHUV, Lausanne, Switzerland.
authors.forename: Anne
authors.initials: A
authors.lastname: Cairoli
authors.affiliation: University Hospital Zürich, Zürich, Switzerland.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Samaras
authors.affiliation: Kantonsspital Baden, Baden, Switzerland.
authors.forename: Clemens B
authors.initials: CB
authors.lastname: Caspar
authors.affiliation: University Hospital Geneva, Geneva, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Mach
authors.affiliation: University Hospital Basel, Basel, Switzerland.
authors.forename: Fatime
authors.initials: F
authors.lastname: Krasniqi
authors.affiliation: Triemli Hospital Zürich, Zürich, Switzerland.
authors.forename: Adrian
authors.initials: A
authors.lastname: Schmidt
authors.affiliation: Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Rothermundt
authors.affiliation: SAKK Coordinating Centre, Bern, Switzerland.
authors.forename: Milica
authors.initials: M
authors.lastname: Enoiu
authors.affiliation: SAKK Coordinating Centre, Bern, Switzerland.
authors.forename: Katrin
authors.initials: K
authors.lastname: Eckhardt
authors.affiliation: SAKK Coordinating Centre, Bern, Switzerland.
authors.forename: Simona
authors.initials: S
authors.lastname: Berardi Vilei
authors.affiliation: SAKK Coordinating Centre, Bern, Switzerland.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Rondeau
authors.affiliation: Kantonsspital Graubünden, Chur, Switzerland.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000069461:Bendamustine Hydrochloride / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012074:Remission Induction / Q000379:methods; D000069283:Rituximab / Q000008:administration & dosage*; D016879:Salvage Therapy; D015996:Survival Rate; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D018943:Anthracyclines; D000069283:Rituximab; D013792:Thalidomide; D000069461:Bendamustine Hydrochloride; D000077269:Lenalidomide
keywords: aggressive-B cell lymphoma; bendamustine; lenalidomide; relapse; rituximab