title: Retrospective analysis of bendamustine and rituximab use in indolent and mantle cell non-Hodgkin lymphoma based on initial starting dose.
abstract: The initial dose of bendamustine, an alkylating agent used in treating indolent lymphoma (iNHL) and mantle cell lymphoma, is variable in clinical practice. 134 patients treated with bendamustine and rituximab were evaluated for starting dosage, patient characteristics, toxicities, and clinical outcome. The starting dosage ranged from 50 to 90 mg/m2. Lower starting dosage (<90 mg/m2) was associated with relapsed disease, increased age and worse performance status (PS), histologic subtype other than follicular lymphoma, baseline renal impairment, and cytopenias. No significant difference was observed in toxicities between patients treated with 90 mg/m2compared with lower doses. The starting dose of 90 mg/m2was associated with a higher complete response rate (56% vs. 29%) and longer progression free survival (PFS) (39.5 months vs. 19.7 months). However, in a multivariable model, the higher starting dose was not associated with longer PFS in those with similar age, histology, PS, and number of prior therapies.
authors.affiliation: a Department of Internal Medicine , The Ohio State University , Columbus , OH , USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Bond
authors.affiliation: b Division of Hematology , The Ohio State University , Columbus , OH , USA.
authors.forename: Ying
authors.initials: Y
authors.lastname: Huang
authors.affiliation: b Division of Hematology , The Ohio State University , Columbus , OH , USA.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Ruppert
authors.affiliation: b Division of Hematology , The Ohio State University , Columbus , OH , USA.
authors.forename: Alison R
authors.initials: AR
authors.lastname: Walker
authors.affiliation: c Department of Pharmacy , The Ohio State University , Columbus , OH , USA.
authors.forename: Emily K
authors.initials: EK
authors.lastname: Dotson
authors.affiliation: c Department of Pharmacy , The Ohio State University , Columbus , OH , USA.
authors.forename: Julianna
authors.initials: J
authors.lastname: Roddy
authors.affiliation: b Division of Hematology , The Ohio State University , Columbus , OH , USA.
authors.forename: Kristie A
authors.initials: KA
authors.lastname: Blum
authors.affiliation: b Division of Hematology , The Ohio State University , Columbus , OH , USA.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Christian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000069461:Bendamustine Hydrochloride / Q000008:administration & dosage; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D000069283:Rituximab / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000069283:Rituximab; D000069461:Bendamustine Hydrochloride
keywords: Bendamustine; immunotherapeutic approaches; lymphoma and Hodgkin disease