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Ann Hematol. 2016 Jun;95(7):1107-14. doi: 10.1007/s00277-016-2668-0. Epub 2016 Apr 22.

Bendamustine plus rituximab versus R-CHOP as first-line treatment for patients with indolent non-Hodgkin's lymphoma: evidence from a multicenter, retrospective study.

Author information

1
Department of Human Pathology, University of Messina, Via Consolare Valeria, 98125, Messina, Italy. patriziamondello@hotmail.it.
2
Department of Biological and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D'Alcontres n°31, 98166, Messina, Italy. patriziamondello@hotmail.it.
3
Lymphoma Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box 330, New York, NY, 10065, USA. patriziamondello@hotmail.it.
4
Internal Medicine V: Hematology & Oncology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
5
Hematology, DISM, AOUD S. M. Misericordia, Piazzale Santa Maria della Misericordia, 33100, Udine, Italy.
6
Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Via 8 Febbraio 1848, 35122, Padova, Italy.
7
Department of Internal Medicine, Pordenone General Hospital, Via Montereale, 33170, Pordenone, Italy.
8
Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, via Nizza 52, 10126, Turin, Italy.
9
Department of Human Pathology, University of Messina, Via Consolare Valeria, 98125, Messina, Italy.
10
Department of Biological and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D'Alcontres n°31, 98166, Messina, Italy.
11
Department of Hematology & CBMT, Ospedale di Bolzano, Via Lorenz Böhler, 5, Bolzano, Italy.

Abstract

The optimal first-line treatment for advanced low-grade non-Hodgkin lymphomas (LG-NHL) is still highly debated. Recently, the StiL and the BRIGHT trials showed that the combination of rituximab and bendamustine (R-B) is non-inferior to rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) with a better toxicity profile. Utilizing a retrospective analysis, we compared the efficacy and safety of both regimens in clinical practice. From November 1995 to January 2014, 263 LG-NHL patients treated with either R-B or R-CHOP were retrospectively assessed in seven European cancer centers. Ninety patients were treated with R-B and 173 with R-CHOP. Overall response rate was 94 and 92 % for the R-B and the R-CHOP group, respectively. The percentage of complete response was similar for both groups (63 vs. 66 % with R-B and R-CHOP, respectively; p = 0.8). R-B was better tolerated and less toxic than R-CHOP. The median follow-up was 6.8 and 5.9 years for the R-CHOP and the R-B group, respectively. Overall, no difference in progression-free survival (PFS) (108 vs. 110 months; p = 0.1) was observed in the R-B group compared to the R-CHOP cohort. Nevertheless, R-B significantly prolonged PFS in FL patients (152 and 132 months in the R-B and R-CHOP group, respectively; p = 0.05). However, this result was not verified in multivariate analysis probably due to the limits of the present study. We confirm that the R-B regimen administered in patients with LG-NHL is an effective and less toxic therapeutic option than R-CHOP in clinical practice.

KEYWORDS:

Bendamustine; First-line therapy; Follicular lymphoma; Indolent lymphoma; R-CHOP

PMID:
27103007
DOI:
10.1007/s00277-016-2668-0
[Indexed for MEDLINE]

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