title: Bendamustine and Rituximab, as First Line Treatment, in Intermediate, High Risk Splenic Marginal Zone Lymphomas of Elderly Patients.
abstract: BACKGROUND
  Splenic marginal zone lymphoma (SMZL) is a chronic B-cell lymphoproliferative disorder, comprising less than 2% of non-Hodgkin's lymphomas, and affecting mainly middle-aged and elderly patients with a median survival of >10 years. The typical clinical features of SMZL include splenomegaly. Treatment should be patient-tailored and can range from a 'watchful waiting' approach for asymptomatic patients without cytopenias to surgery, localized radiation therapy or immuno/chemotherapies. Recently, the combination of rituximab and Bendamustine (R-Benda) has been defined as highly active in patients with follicular lymphomas, but little is known about the efficacy of R-Benda in SMZL.
  
  
  OBJECTIVE
  The purpose of this retrospective study was to report our experience on the efficacy of R-Benda as first line treatment in 23 consecutive elderly SMZL patients.
  
  
  RESULTS
  All patients had a complete resolution of splenomegaly along with restoration of their blood counts. Nineteen patients (83%) achieved a complete response (CR) to therapy; three patients (13%) achieved a partial response (PR).Ten patients (43%) obtained molecular remission. Toxicities were mild and mainly haematological and result in dose reductions for fourteen patients.
  
  
  CONCLUSIONS
  Our data suggest a high activity and good tolerance of R-Benda, despite dose reduction due to potential toxicity.
authors.affiliation: Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Luigi Sacco Hospital Milan, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Castelli
authors.affiliation: Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Luigi Sacco Hospital Milan, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gidaro
authors.affiliation: Fondazione Mattarelli Milano.
authors.forename: Giorgio Lambertenghi
authors.initials: GL
authors.lastname: Deliliers