title: Clinical Outcomes Related to the Use of Bendamustine Therapy for Multiple Myeloma Patients Relapsed/Refractory to Immunomodulatory Drugs and Proteasome Inhibitors.
abstract: OBJECTIVE
  Multiple myeloma patients who are relapsed or refractory to both proteasome inhibitors (PIs) and immunomodulatory drugs (IMiDs) have been reported to have poor outcomes. Bendamustine has been reported to have an antitumor effect in newly diagnosed as well as relapsed/refractory multiple myeloma (RRMM). The aim of this retrospective study was to evaluate the efficacy of bendamustine therapy in heavily pretreated MM patients who were refractory to PIs and IMiDs.
  
  
  METHODS
  Nineteen RRMM patients treated either with bendamustine and steroids (n=13) or a combination of bendamustine with novel drugs (n=6) were included. The median number of previous treatment lines was 5 (minimum-maximum: 3-8) and median time from diagnosis was 6 years (minimum-maximum: 1-16). All of the patients were resistant to at least one of the IMiDs and one of the PIs. Bendamustine was given at doses ranging from 90 mg/m2 to 120 mg/m2 on days 1 and 2 of 28-day cycles.
  
  
  RESULTS
  A median of 2 (minimum-maximum: 1-8) treatment cycles was administered per patient. The toxicity of bendamustine was mild and mostly of hematological origin. No complete remission was achieved. There was partial remission and stable disease in 21% and 11% of the patients, respectively. Sixty-eight percent of patients had progressive disease. The median progression-free survival and overall survival was 2 and 4 months, respectively.
  
  
  CONCLUSIONS
  Bendamustine therapy was well tolerated but showed limited anti-myeloma activity in heavily pretreated patients who were refractory to IMiDs and PIs.
authors.affiliation: İstanbul University Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey.
authors.forename: Fevzi Fırat
authors.initials: FF
authors.lastname: Yalnız
authors.forename: Nihan
authors.initials: N
authors.lastname: Akkoç
authors.forename: Ayşe
authors.initials: A
authors.lastname: Salihoğlu
authors.forename: M Cem
authors.initials: MC
authors.lastname: Ar
authors.forename: Şeniz
authors.initials: Ş
authors.lastname: Öngören
authors.forename: A Emre
authors.initials: AE
authors.lastname: Eşkazan
authors.forename: Teoman
authors.initials: T
authors.lastname: Soysal
authors.forename: Yıldız
authors.initials: Y
authors.lastname: Aydın
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000069461:Bendamustine Hydrochloride / Q000008:administration & dosage*; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality*; D061988:Proteasome Inhibitors / Q000008:administration & dosage*; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D061988:Proteasome Inhibitors; D000069461:Bendamustine Hydrochloride