Review article

https://doi.org/10.20471/acc.2018.57.03.18

Bendamustine: an Old Drug in the New Era for Patients with Non-Hodgkin Lymphomas and Chronic Lymphocytic Leukemia

Martina Bogeljić Patekar orcid.org/0000-0003-2199-3681 ; Division of Hematology, Merkur University Hospital, Zagreb, Croatia
Vibor Milunović ; Division of Hematology, Merkur University Hospital, Zagreb, Croatia; Lombardi Comprehensive Cancer Centre, Georgetown University, Washington. D.C., United States of America
Karla Mišura Jakobac ; Division of Hematology, Merkur University Hospital, Zagreb, Croatia
Dražen Perica ; School of Medicine, University of Zagreb, Zagreb, Croatia
Inga Mandac Rogulj ; Division of Hematology, Merkur University Hospital, Zagreb, Croatia
Marin Kursar ; Division of Hematology, Merkur University Hospital, Zagreb, Croatia
Ana Planinc-Peraica ; Division of Hematology, Merkur University Hospital, Zagreb, Croatia; Lombardi Comprehensive Cancer Centre, Georgetown University, Washington. D.C., United States of America
Slobodanka Ostojić Kolonić ; Division of Hematology, Merkur University Hospital, Zagreb, Croatia; Lombardi Comprehensive Cancer Centre, Georgetown University, Washington. D.C., United States of America

Abstract

The aim of this review is to present data on bendamustine, a non-cross resistant alkylating agent, alone or in combination for treatment of non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL). Bendamustine is currently approved for rituximab-resistant indolent NHL and CLL in patients not fit for conventional chemotherapy. Recent studies have shown superiority of bendamustine combination with rituximab (B-R) in first line treatment of indolent NHLs and mantle cell lymphoma, suggesting a shift of the standard of care in this setting. B-R regimen has also shown efficacy in relapsed setting suggesting the possible treatment option for patients failing conventional chemotherapy. In rituximab-resistant NHL, the recent GADOLIN study exploring the addition of obinutuzumab to bendamustine has yielded impressive result changing the standard of care in this hard-to-treat population. Concerning CLL, despite inferiority to the standard of care in young fit patients, as defined in CLL10 study, B-R has yielded a more beneficial toxicity profile and its use in first line treatment should be decided individually. In relapsed setting, the addition of ibrutinib to B-R has shown superior results compared to B-R alone, possibly changing the paradigm of treatment of relapsed CLL. In conclusion, bendamustine as a single agent or in combinations has shown activity with acceptable toxic profile in the treatment of patients with indolent NHLs or CLL without del(17p) mutation.

Keywords

Bendamustine hydrochloride; Alkylating agents; Lymphoma, non-Hodgkin; Rituximab; Leukemia, lymphocytic, chronic, B-cell; Obinutuzumab

Hrčak ID:

216163

URI

https://hrcak.srce.hr/216163

Publication date:

1.9.2018.

Article data in other languages: croatian

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