Bendamustine added to allogeneic conditioning improves long-term outcomes in patients with CLL.
Bendamustine has shown a favorable safety profile when included in chemotherapy regimens for several types of lymphoma, including CLL. This study investigated the long-term effect of adding bendamustine to a conditioning regimen on survival, rate of engraftment, immune recovery and GvHD after allogeneic stem cell transplantation (alloSCT) in CLL patients. These outcomes were compared with the fludarabine, cyclophosphamide and rituximab (FCR) conditioning regimen. We reviewed the data for 89 CLL patients treated on three trials at our institution. Twenty-six (29%) patients received bendamustine, fludarabine and rituximab (BFR) and 63 (71%) received FCR. Patient characteristics were similar in both groups. Ten (38%) BFR-treated patients vs only two (3%) FCR-treated patients did not experience severe neutropenia (P=<0.001). The 3-year overall survival estimates for the BFR and FCR groups were 82 and 51% (P=0.03), and the 3-year PFS estimates were 63% and 27% (P=0.001), respectively. The 2-year treatment-related mortality was 8 and 23% and the incidence of grade 3 or 4 GvHD was 4% and 10%, respectively. This study is the first to report that addition of bendamustine to alloSCT conditioning for CLL patients is associated with improved survival and lower mortality, myelosuppression, and GvHD.
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
I F
IF
Khouri
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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D
Sui
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
E J
EJ
Jabbour
Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
B I
BI
Samuels
Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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F
Turturro
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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G
Alatrash
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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P
Anderlini
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
S
S
Ahmed
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
B
B
Oran
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
S O
SO
Ciurea
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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D
Marin
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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http://orcid.org/0000-0002-1669-0355
A
Olson
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
K K
KK
Patel
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
U R
UR
Popat
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
C
C
Ledesma
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
T M
TM
Kadia
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
A
A
Ferrajoli
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
J A
JA
Burger
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
J L
JL
Jorgensen
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
L J
LJ
Medeiros
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
R L
RL
Bassett
The Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Gulbis
D000328:Adult; D000368:Aged; D000069461:Bendamustine Hydrochloride / Q000008:administration & dosage*; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D000069283:Rituximab / Q000008:administration & dosage; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods*; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives
D000069283:Rituximab; D003520:Cyclophosphamide; D000069461:Bendamustine Hydrochloride; D014740:Vidarabine; C024352:fludarabine