Bendamustine in combination with ifosfamide, etoposide, and vinorelbine (VIBE) is an effective salvage regimen for heavily pre-treated patients with relapsed or refractory Hodgkin lymphoma: a single-center experience

Gaurav Prakash,Arihant Jain,Kamalkant Sahu,Amanjit Bal,Charanpreet Singh,Rajender Basher,Harmandeep Singh,Kundan Mishra,Aditya Jandial,Deepesh Lad,Alka Khadwal,Radhika Srinivasan,Ashim Das,Neelam Varm 대한혈액학회 2021 Blood Research Vol.56 No.3

Background This study evaluated the outcomes of patients with refractory/relapsed Hodgkin lymphoma (RRHL) treated with a bendamustine-based regimen in combination with ifosfamide, etoposide, and vinorelbine (VIBE). Methods Consecutive RRHL patients who were treated with the VIBE regimen were identified and studied for clinicopathologic characteristics, response to VIBE regimen, event-free survival (EFS), and feasibility of an autologous stem-cell transplant (autoSCT). Results In total, 24 patients received the VIBE regimen, and a median of 3 cycles were administered. In this cohort, 80% of the patients had received ≥2 prior lines of therapy. The overall and complete response rates with VIBE were 79% and 42%, respectively. After a median follow-up (following VIBE regimen) of 14 months (range, 3‒76), the 3-year EFS and OS were 46% and 74%, respectively. Of the eligible patients, 92% underwent successful AutoSCT. The mean CD34+ cell count in the autograft was 5.5×106 /kg (SD 2.07). Neutropenia was the commonest hematologic toxicity and it was observed in 42% of the patients. However, only 9% of the patients developed grade III/IV febrile neutropenia. Chemotherapy-induced nausea and vomiting were the second most common grade III/IV toxicities in our cohort of patients. Conclusion In this retrospective analysis, the combination regimen, VIBE, has shown good efficacy in heavily pre-treated patients with RRHL without compromising stem cell collection. These encouraging results provide a rationale for further development of this regimen.

Mantle Cell Lymphoma: A North Indian Tertiary Care Centre Experience

Das, Chandan Krushna,Gogia, Ajay,Kumar, Lalit,Sharma, Atul,Sharma, Mehar Chand,Mallick, Saumya Ranjan Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.10

Background: Mantle cell lymphoma (MCL) is an aggressive non-Hodgkin's lymphoma, with a pathognomonic chromosomal translocation t (11;14). Prognosis is uniformly dismal but there is a paucity of information on MCL from India. Materials and methods: We retrospectively analysed clinicopathological information on all treated patients with MCL at our centre. STATA 14.0 was used for analysis. Survival was assessed by Kaplan-Meier analysis and the Cox's proportional hazards method. Statistical significance was defined as a P value of < 0.05. Results: Fifty-one patients with MCL were reviewed. The median age at presentation was 57.0 years. Extranodal involvement was seen in 39.0 (74.0%) while bone marrow positivity at presentation was found in 27.0 (54.0%). Initial treatment was chemotherapy with or without rituximab. Patients receiving rituximab-based therapy (n = 24) had 5-year progression-free survival (PFS) of 21.0 (88.0%), compared with 14.0 (61.0%) for those not receiving rituximab (n = 23, P = 0.036). Twenty-three patients were alive with a median follow-up of 20.7 months (range 2.5-89.2). PFS at 1 and 2 years was 51.0% and 27.0%, and overall survival (OS) 78.0% and 72.0%, respectively. Use of more than 2.0 lines of therapy, use of bendamustine-rituximab, and high TLC (>10,000.0/cu.mm) significantly affected PFS. Conclusions: In our experience, MCL patients from north India have an early age at presentation. When treated with regimens including rituximab results in an improved response rate and PFS. This study provided comprehensive insights into the treatment of MCL in a developing country.

Bendamustine in heavily pre-treated multiple myeloma patients: Results of a retrospective analysis from the Korean Multiple Myeloma Working Party

김석진,Soo-Mee Bang,최윤석,조덕연,김진석,Hyewon Lee,Hyeon Seok Eom,윤덕현,서철원,이제중,Junshik Hong,이재훈,Youngil Koh,김기현,윤성수,민창기 대한혈액학회 2016 Blood Research Vol.51 No.3

BackgroundBendamustine may be a potential treatment option for patients with myeloma, but little is known about the utility of bendamustine as a salvage treatment, especially in Asian patients.MethodsWe performed a multicenter retrospective study of patients with relapsed or refractory myeloma who received bendamustine and prednisone. ResultsThe records of 65 heavily pre-treated patients, who had undergone bortezomib and lenali-domide treatment (median number of previous treatments: 5), were analyzed. The me-dian time from diagnosis to bendamustine treatment was 3.8 years, and the median pa-tient age was 63 years (range, 38‒77 yr). The responses to the last treatment before bend-amustine were refractory disease (N=52, 80%) or disease progression from partial re-sponse (N=13, 20%). Twenty-three patients responded to the treatment, with an overall response rate of 35% (23/65), and the median number of bendamustine treatment cycles was two (range, 1‒5 cycles). The median overall survival after bendamustine treatment was 5.5 months and the overall survival rate in responders to bendamustine was sig-nificantly better than that in non-responders (P=0.036). ConclusionBendamustine may be a potential salvage treatment to extend survival in a select group of heavily pre-treated patients with relapsed or refractory myeloma.

Bendamustine in heavily pre-treated multiple myeloma patients: Results of a retrospective analysis from the Korean Multiple Myeloma Working Party

김석진,Soo-Mee Bang,최윤석,조덕연,김진석,Hyewon Lee,Hyeon Seok Eom,윤덕현,서철원,이제중,Junshik Hong,이재훈,Youngil Koh,김기현,윤성수,민창기 대한혈액학회 2016 Blood Research Vol.51 No.3

BackgroundBendamustine may be a potential treatment option for patients with myeloma, but little is known about the utility of bendamustine as a salvage treatment, especially in Asian patients.MethodsWe performed a multicenter retrospective study of patients with relapsed or refractory myeloma who received bendamustine and prednisone. ResultsThe records of 65 heavily pre-treated patients, who had undergone bortezomib and lenali-domide treatment (median number of previous treatments: 5), were analyzed. The me-dian time from diagnosis to bendamustine treatment was 3.8 years, and the median pa-tient age was 63 years (range, 38‒77 yr). The responses to the last treatment before bend-amustine were refractory disease (N=52, 80%) or disease progression from partial re-sponse (N=13, 20%). Twenty-three patients responded to the treatment, with an overall response rate of 35% (23/65), and the median number of bendamustine treatment cycles was two (range, 1‒5 cycles). The median overall survival after bendamustine treatment was 5.5 months and the overall survival rate in responders to bendamustine was sig-nificantly better than that in non-responders (P=0.036). ConclusionBendamustine may be a potential salvage treatment to extend survival in a select group of heavily pre-treated patients with relapsed or refractory myeloma.

Bendamustine, etoposide, and dexamethasone to mobilize peripheral blood hematopoietic stem cells for autologous transplantation in non-Hodgkin lymphoma

Adam M. Greenbaum,Damian J. Green,Leona A. Holmberg,Ted Gooley,Brian G. Till,Lihua E. Budde,Heather Rasmussen,Oliver W. Press,Ajay K. Gopal 대한혈액학회 2018 Blood Research Vol.53 No.3

Background Bendamustine is a chemotherapeutic agent that has shown broad activity in patients with lymphoid malignancies. It contains both alkylating and nucleoside analog moieties, and thus, is not commonly used for stem cell mobilization due to concerns that it may ad-versely affect stem cell collection. Here we describe the lymphoma subset of a pro-spective, non-randomized phase II study of bendamustine, etoposide, and dex-amethasone (BED) as a mobilization agent for lymphoid malignancies. Methods This subset analysis includes diffuse large B-cell lymphoma (N=3), follicular lymphoma (N=1), primary mediastinal B-cell lymphoma (N=1), and NK/T-cell lymphoma (N=1). Patients received bendamustine (120 mg/m2 IV d 1, 2), etoposide (200 mg/m2 IV d 1‒3), and dexamethasone (40 mg PO d 1‒4) followed by filgrastim (10 mcg/kg/d sc. through collection). Results We successfully collected stem cells from all patients, with a median of 7.9×106/kg of body weight (range, 4.4 to 17.3×106/kg) over a median of 1.5 days (range, 1 to 3) of apheresis. All patients who received transplants were engrafted using kinetics that were comparable to those of other mobilization regimens. Three non-hematologic significant adverse events were observed in one patient, and included bacterial sepsis (grade 3), tumor lysis syndrome (grade 3), and disease progression (grade 5). Conclusion For non-Hodgkin lymphoma, mobilization with bendamustine is safe and effective.

Bendamustine, etoposide, and dexamethasone to mobilize peripheral blood hematopoietic stem cells for autologous transplantation in non-Hodgkin lymphoma

Adam M. Greenbaum,Damian J. Green,Leona A. Holmberg,Ted Gooley,Brian G. Till,Lihua E. Budde,Heather Rasmussen,Oliver W. Press,Ajay K. Gopal 대한혈액학회 2018 Blood Research Vol.53 No.3

Background Bendamustine is a chemotherapeutic agent that has shown broad activity in patients with lymphoid malignancies. It contains both alkylating and nucleoside analog moieties, and thus, is not commonly used for stem cell mobilization due to concerns that it may ad-versely affect stem cell collection. Here we describe the lymphoma subset of a pro-spective, non-randomized phase II study of bendamustine, etoposide, and dex-amethasone (BED) as a mobilization agent for lymphoid malignancies. Methods This subset analysis includes diffuse large B-cell lymphoma (N=3), follicular lymphoma (N=1), primary mediastinal B-cell lymphoma (N=1), and NK/T-cell lymphoma (N=1). Patients received bendamustine (120 mg/m2 IV d 1, 2), etoposide (200 mg/m2 IV d 1‒3), and dexamethasone (40 mg PO d 1‒4) followed by filgrastim (10 mcg/kg/d sc. through collection). Results We successfully collected stem cells from all patients, with a median of 7.9×106/kg of body weight (range, 4.4 to 17.3×106/kg) over a median of 1.5 days (range, 1 to 3) of apheresis. All patients who received transplants were engrafted using kinetics that were comparable to those of other mobilization regimens. Three non-hematologic significant adverse events were observed in one patient, and included bacterial sepsis (grade 3), tumor lysis syndrome (grade 3), and disease progression (grade 5). Conclusion For non-Hodgkin lymphoma, mobilization with bendamustine is safe and effective.

Safety and efficacy of bendamustine in the conditioning regimen for autologous stem cell transplantation in patients with relapsed/refractory lymphoma

Munira Shabbir-Moosajee,Samad Jehangir,Sobiya Sawani,Tariq Muhammed,Natasha Ali,Usman Sheikh,Salman Adil 대한혈액학회 2019 Blood Research Vol.54 No.2

BackgroundBendamustine is an attractive option for the management of both de novo and relapsed lymphomas. It is being increasingly used in the conditioning regimen for autologous stem cell transplantation (SCT) and can be an alternative to the traditionally-used carmustine. In this study, we aimed to determine the safety and efficacy of bendamustine in the con-ditioning regimen for autologous SCT in refractory/relapsed lymphomas.MethodsWe designed a descriptive study to evaluate bendamustine in combination with etopo-side, cytarabine, and melphalan (BeEAM) in the conditioning regimen for autologous SCT.ResultsFourteen patients (median age, 28 yr) with Hodgkin’s lymphoma (HL) (N=8), non-Hodgkin’s lymphomas (NHL) (N=5), or peripheral T-cell lymphoma, not otherwise specified (PTCL NOS) (N=1) were included in the study. A median number of 5.95×106CD34+ cells/kg were transfused. Median times to absolute neutrophil count and platelet engraftment were 17 days and 24 days, respectively. The 100-day transplantation mortal-ity rate was 28% (4 patients). Eight patients (57.14%) had GII-III acute kidney injury, four patients (28.5%) had GIII-IV hyperbilirubinemia, and twelve patients (85%) had GII-III diarrhea. After 3 months, 37% (5 patients) and 21.4% (3 patients) demonstrated complete response and partial response, respectively. The median follow-up was 5.5 months (15 days‒19 mo). At the final follow-up, 7 patients (50%) were alive and in CR.ConclusionOur study showed that bendamustine is a potentially toxic agent in the conditioning regi-men for autologous SCT, resulting in significant liver, kidney, and gastrointestinal toxicity. Further studies are required to assess its safety and efficacy at reduced doses.

Spontaneous Improvement of Eosinophilic Dermatosis of Hematologic Malignancy Concurrent with Follicular Lymphoma after Rituximab and Bendamustine Therapy

( Kyung-deok Park ),( Dong-wha Yoo ),( Hyeok-jin Kwon ),( Jang-hoon Yi ),( Ho-jin Kim ),( Ki-ho Kim ),( Jung-ho Yoon ) 대한피부과학회 2024 대한피부과학회지 Vol.62 No.3

Eosinophilic dermatosis of hematological malignancy (EDHM) is a rare condition associated with various hematologic malignancies, characterized by pruritic skin eruptions. We present a case of a 66-year-old woman with follicular lymphoma who developed urticarial and vesicular lesions indicative of EDHM following chemotherapy. The diagnosis was confirmed through histological analysis, revealing eosinophilic infiltration. Treatment included additional chemotherapy sessions and topical corticosteroids, resulting in complete resolution of skin lesions and lymphoma. EDHM requires careful differentiation based on clinical and histological findings. The pathogenesis remains unclear, but addressing underlying hematologic malignancies appears crucial in management. Early recognition of EDHM is essential for appropriate intervention due to its limited therapeutic options. (Korean J Dermatol 2024;62(3):172∼176)