title: Bendamustine and Rituximab: Complete Response in a 62-Year-Old Female with an Aggressive Lymphoma and an Ejection Fraction of 20.
abstract: The treatment of diffuse large B-cell lymphoma in the presence of cardiac comorbidities can be challenging considering that the standard treatment regimen used for this aggressive subtype of non-Hodgkin lymphoma (NHL) consists of a combination of rituximab, cyclophosphamide, doxorubicin hydrochloride, Oncovin (vincristine), and prednisone (R-CHOP). The use of the anthracycline doxorubicin has been associated with arrhythmias and cardiomyopathy, making patients with cardiac dysfunction poor candidates for R-CHOP. As such, it is imperative to find alternative regimens that omit cardiac toxicity without compromising efficacy for this patient population. We report a case of composite NHL in a patient who received frontline bendamustine with rituximab with encouraging results. Our patient had a left ventricular ejection fraction of 20%, making her a poor candidate for anthracycline-based therapy. We opted to administer bendamustine with rituximab for a total of 6 cycles. She remains disease free 18 months after the completion of therapy.
authors.affiliation: Division of Hematology/Oncology/Cell Therapy, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Taha
authors.initials: T
authors.lastname: Alrifai
authors.forename: Kelly
authors.initials: K
authors.lastname: Grant Szymanski
authors.forename: Parameswaran
authors.initials: P
authors.lastname: Venugopal
authors.forename: Brett
authors.initials: B
authors.lastname: Mahon
authors.forename: Tochukwu
authors.initials: T
authors.lastname: Okwuosa
authors.forename: Reem
authors.initials: R
authors.lastname: Karmali
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D000069461:Bendamustine Hydrochloride / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000188:drug therapy*; D008875:Middle Aged; D000069283:Rituximab / Q000008:administration & dosage*; D013318:Stroke Volume / Q000187:drug effects* / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D000069283:Rituximab; D000069461:Bendamustine Hydrochloride