title: Bendamustine for the treatment of relapsed or refractory peripheral T cell lymphomas: A French retrospective multicenter study.
abstract: Peripheral T-cell lymphoma (PTCL) is a group of diseases with poor outcome and few therapeutic options. We aimed to assess the efficacy of bendamustine in real life cohort of patients.Between November 2009 and March 2015, 138 PTCL patients were treated with bendamustine in 27 centers. Population median age was 64 (28-89) years with male/female ratio of 1.4. There were mainly angio-immunoblastic (AITL = 71), PTCL-not otherwise specified (PTCL-NOS = 40) and anaplastic large cell lymphoma (ALCL = 8). The majority of patients (96%) had disseminated disease and extranodal localizations (77%). Median number of chemotherapy lines prior to bendamustine was 2 (1-8). Median duration of response (DoR) after the last chemotherapy prior to bendamustine was 4.3 months (1-70) and 50% of patients had refractory disease.Median number of administered bendamustine cycles was 2 (1-8) and 72 patients (52%) received less than 3 mostly because of disease progression. Median dose was 90 (50-150) mg/m². Overall response rate (ORR) was 32.6% with complete response (CR) rate of 24.6% and median DoR was 3.3 months (1-39). AITL patients were more sensitive than PTCL-NOS patients (ORR: 45.1 versus 20%, p = 0.01). Median PFS and OS were 3.1 (0.2-46.3) and 4.4 (0.2-55.4) months. On multivariate analysis, refractory disease (p = 0.001) and extranodal localization (p = 0.028) adversely influenced ORR. Grade 3-4 thrombocytopenia, neutropenia and infections were reported in 22, 17 and 23% of cases respectively.Bendamustine as single agent could be considered as a therapeutic option for relapsed or refractory PTCL, particularly in chemosensitive or AITL patients. Combinations of bendamustine with other drugs warrant further evaluation.
authors.affiliation: Department of Hematology, University Hospital of Caen, Caen, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Reboursiere
authors.affiliation: Department of Hematology, Assistance Publique des Hôpitaux de Paris, Créteil, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Le Bras
authors.affiliation: Department of Hematology, University and Regional Hospital of Lille, Lille, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Herbaux
authors.affiliation: Department of Hematology, University Hospital of Tours, UMR CNRS, Tours, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Gyan
authors.affiliation: Department of Hematology, University Hospital of Angers, Angers, France.
authors.forename: Aline
authors.initials: A
authors.lastname: Clavert
authors.affiliation: Department of Hematology, University and Regional Hospital of Lille, Lille, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Morschhauser
authors.affiliation: Department of Hematology, Institut Curie, Paris, France.
authors.forename: Sandra
authors.initials: S
authors.lastname: Malak
authors.affiliation: Department of Hematology, Hôpital Necker-Enfants Malades, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Sibon
authors.affiliation: Department of Hematology, Institut Paoli Calmettes, Marseille, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Broussais
authors.affiliation: Department of Hematology, Hôpital Avicenne, Bobigny, France.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Braun
authors.affiliation: Department of Hematology, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Luc-Matthieu
authors.initials: LM
authors.lastname: Fornecker
authors.affiliation: Department of Hematology, Saint Quentin Hospital, Saint Quentin, France.
authors.forename: Reda
authors.initials: R
authors.lastname: Garidi
authors.affiliation: Department of Hematology, Centre Hospitalier Valenciennes, Valenciennes, France.
authors.forename: Sabine
authors.initials: S
authors.lastname: Tricot
authors.affiliation: Department of Hematology, University Hospital Pontchaillot, Rennes, France.
authors.forename: Roch
authors.initials: R
authors.lastname: Houot
authors.affiliation: Department of Hematology, Centre Hospitalier Sud Francilien, Corbeil, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Joly
authors.affiliation: Department of Hematology, Meaux Hospital, Meaux, France.
authors.forename: Wajed
authors.initials: W
authors.lastname: Abarah
authors.affiliation: Department of Hematology, Boulogne-sur-Mer Hospital, Boulogne-sur-Mer, France.
authors.forename: Bachra
authors.initials: B
authors.lastname: Choufi
authors.affiliation: Department of Biostatistics and Clinical Research, University Hospital of Caen, Caen, France.
authors.forename: Anne-Dominique
authors.initials: AD
authors.lastname: Pham
authors.affiliation: Department of Hematology, University Hospital of Caen, Caen, France.
authors.forename: Anne-Claire
authors.initials: AC
authors.lastname: Gac
authors.affiliation: Department of Hematology, University Hospital of Caen, Caen, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Fruchart
authors.affiliation: Department of Hematology, University Hospital of Caen, Caen, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Marin
authors.affiliation: Department of Hematology, Hospices Civils de Lyon, Pierre-Benite, France.
authors.forename: Violaine
authors.initials: V
authors.lastname: Safar
authors.affiliation: Department of Hematology, University Hospital of Amiens, Amiens, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Parcelier
authors.affiliation: Department of Hematology, La Roche-sur-Yon Hospital, La Roche sur-Yon, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Maisonneuve
authors.affiliation: Department of Hematology, Hospices Civils de Lyon, Pierre-Benite, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bachy
authors.affiliation: Department of Hematology, Université Montpellier, CHRU, UMR CNRS, Montpellier, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Cartron
authors.affiliation: Department of Hematology, University Hospital of Limoges, Limoges, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Jaccard
authors.affiliation: Department of Hematology, University Hospital of Clermont-Ferrand, Clermont Ferrand, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Tournilhac
authors.affiliation: Department of Hematology, University Hospital of Dijon, Dijon, France.
authors.forename: Cédric
authors.initials: C
authors.lastname: Rossi
authors.affiliation: Department of Hematology, University Hospital of Nancy, Vandoeuvre Les Nancy, France.
authors.forename: Luciane
authors.initials: L
authors.lastname: Schirmer
authors.affiliation: Department of Hematology, Institut de Cancérologie Lucien Neuwirth, Saint-Etienne, France.
authors.forename: Jean-Alain
authors.initials: JA
authors.lastname: Martignoles
authors.affiliation: Department of Pathology, University Paris Est, Hôpital Henri Mondor, Créteil, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gaulard
authors.affiliation: Department of Hematology, Centre Henri Becquerel, Rouen, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Tilly
authors.affiliation: Department of Hematology, University Hospital of Caen, Caen, France.|Microenvironnement Cellulaire et Pathologies, Normandie University, UNICAEN, MILPAT, Caen, France.
authors.forename: Gandhi
authors.initials: G
authors.lastname: Damaj
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage* / Q000009:adverse effects; D000069461:Bendamustine Hydrochloride / Q000008:administration & dosage* / Q000009:adverse effects; D018450:Disease Progression; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D005260:Female; D005602:France; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008207:Lymphatic Metastasis; D016411:Lymphoma, T-Cell, Peripheral / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D000069461:Bendamustine Hydrochloride
keywords: bendamustine; efficacy; peripheral T cell lymphoma; safety