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Bendamustine Therapy in Patients With Relapsed or Refractory Waldenström's Macroglobulinemia

      Abstract

      We report the treatment outcome for 30 relapsed/refractory Waldenström's macroglobulinemia (WM) patients following bendamustine-containing therapy. Treatment consisted of bendamustine (90 mg/m2 I.V. on days 1, 2) and rituximab (375 mg/m2 I.V. on either day 1 or 2) for 24 patients. Six rituximab-intolerant patients received bendamustine alone (n = 4) or with ofatumumab (1000 mg I.V. on day 1; n = 2). Each cycle was 4 weeks, and median number of treatment cycles was 5. At best response, median serum IgM declined from 3980 to 698 mg/dL (P < .0001), and hematocrit rose from 31.9% to 36.6% (P = .0002). Overall response rate was 83.3%, with 5 VGPR and 20 PR. The median estimated progression-free survival for all patients was 13.2 months. Overall therapy was well tolerated. Prolonged myelosuppression was more common in patients who received prior nucleoside analogues. Bendamustine is active and produces durable responses in previously treated WM, both as monotherapy and with CD20-directed monoclonal antibodies.
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      References

        • Leoni LM
        • Bailey B
        • Reifert J
        • et al.
        Bendamustine displays a distinct pattern of cytotoxicity and unique mechanistic features compared with other alkylating agents.
        Clin Cancer Res. 2008; 14: 309-317
        • Cheson BD
        • Rummel MJ
        Bendamustine: Rebirth of an old drug.
        J Clin Oncol. 2009; 27: 1492-1501
        • Friedberg JW
        • Cohen P
        • Chen L
        • et al.
        Bendamustine in patients with rituximab-refractory indolent and transformed non-Hodgkin's lymphoma: results from a phase II multicenter, single-agent study.
        J Clin Oncol. 2008; 26: 204-210
        • Kahl B
        • Bartlett NL
        • Leonard JP
        • et al.
        Bendamustine is effective therapy in patients with rituximab-refractory, indolent B-cell non-Hodgkin lymphoma: results from a Multicenter Study.
        Cancer. 2010; 116: 106-114
        • Rummel MJ
        • Al-Batran SE
        • Kim S-Z
        • et al.
        Bendamustine plus rituximab is effective and has a favorable toxicity profile in the treatment of mantle cell and low-grade Non-Hodgkin's lymphoma.
        J Clin Oncol. 2005; 23: 3383-3389
        • Robinson KS
        • Williams ME
        • van der Jagt RH
        • et al.
        Phase II multicenter study of bendamustine plus rituximab in patients with relapsed indolent B-cell and mantle cell non-Hodgkin's lymphoma.
        J Clin Oncol. 2008; 26: 4473-4479
        • Rummel MJ
        • von Gruenhagen U
        • Niederle N
        • et al.
        Bendamustine plus rituximab versus CHOP plus rituximab in the firstline treatment of pati ents with follicular, indolent and mantle cell lymphomas: Results of a randomized phase III study of the Study Group Indolent Lymphomas (StiL).
        Blood. 2008; (abstract 2596).: 112
      1. Rummel MJ, von Gruenhagen U, Niederle N, et al. Bendamustine plus rituximab versus CHOP plus rituximab in the first-line treatment of patients with Waldenstrom's macroglobulinemia-First interim results of a randomized phase III study of the Studygroup Indolent Lymphomas (StiL). Proceedings of the 5th International Workshop on Waldenstrom's macroglobulinemia, Stockholm, Sweden 2008; Abstract 139.

        • Kimby E
        • Treon SP
        • Anagnostopoulos A
        • et al.
        Update on recommendations for assessing response from the Third International Workshop on Waldenstrom's Macroglobulinemia.
        Clin Lymphoma Myeloma. 2006; 6: 380-383
        • Treon SP
        • Branagan AR
        • Ioakimidis L
        • et al.
        Long term outcomes to fludarabine and rituximab in Waldenstrom's macroglobulinemia.
        Blood. 2009; 113: 3673-3678
        • Treon SP
        How I treat Waldenstrom's macroglobulinemia.
        Blood. 2009; 114: 2375-2385
        • Dimopoulos MA
        • Gertz MA
        • Kastritis E
        • et al.
        Update on treatment recommendations from the Fourth International Workshop on Waldenstrom's Macroglobulinemia.
        J Clin Oncol. 2009; 27: 120-126
        • Rummel MJ
        • Tenzer A
        • Niederle N
        • et al.
        No elevated rates of treatment-related myelodysplastic syndromes and second solid tumors following therapy with bendamustine compared with other anti-lymphoma regimens for low-grade non-Hodgkin's lymphoma.
        Blood. 2010; (abstract 3090).: 116
        • Schmidt-Hieber M
        • Busse A
        • Reufi B
        • et al.
        Bendamustine, but not fludarabine, exhibits low stem cell toxicity in vitro.
        J Cancer Res Clin Oncol. 2009; 135: 227-234