Treatment option of bendamustine in combination with rituximab in elderly and frail patients with aggressive B-non-Hodgkin lymphoma: rational, efficacy, and tolerance
Annals of Hematology, 07/05/2012
Clinical Article
Horn J et al. – The authors conclude that rituximab plus bendamustine (R–B) is a feasible and safe therapy option in aggressive B–non–Hodgkin lymphoma (a–B–NHL) patients not qualifying for R–CHOP.
Methods- The authors assessed 20 consecutive patients with a-B-NHL receiving R-B as first-line or relapse treatment after (R)-CHOP in the department.
- Besides patient- and lymphoma-specific characteristics, comorbidity indices were determined.
- The median patient age was 72years (51–86), the median Karnofsky performance status was 55 % (40–90 %), and according to the international prognostic index, 15 had high-intermediate or high-risk disease.
- The comorbidity indices revealed a median Kaplan–Feinstein index of 3 (range 1–3), Charlson comorbidity index of 4 (range 0–9), hematopoietic cell transplantation-specific comorbidity index of 3 (range 0–11), and Freiburg comorbidity index of 2 (range 0–2).
- Moreover, eight patients had echocardiographic and laboratory signs of cardiac insufficiency, all leading to R-B rather than R-CHOP treatment.
- The overall response rate was 55 %, with complete response and partial response rates of 20 and 35 %, respectively.
- In the frail and elderly patient cohort, R-B therapy was well-tolerated.
- Median progression free survival and overall survival were 8.3months (95 % confidence interval [CI], 2.8—not reached [n.r.]) and 19.4months (95 % CI, 4.6—n.r.), respectively.
