Efficacy and safety of bendamustine for the treatment of patients with recurring Hodgkin lymphoma
Efficacy and safety of bendamustine for the treatment of patients with recurring Hodgkin lymphoma
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DOI：
10.1111/bjh.12120
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发表时间：
2013-01-01
影响因子：
6.5
通讯作者：
Pinto, Antonio
中科院分区：
文献类型：
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作者：
Corazzelli, Gaetano;Angrilli, Francesco;Pinto, Antonio
干细胞移植(SCT)后复发的霍奇金淋巴瘤(HL)患者的治疗仍然具有挑战性。我们报告了41名这样的患者，他们接受了盐酸苯达莫司汀，这是一种机械上与传统烷化剂无关的双功能机械氯胺衍生物，在包括85%的病例的SCT在内的四种先前化疗方案的中位数之后。苯达莫司汀90120 mg/m2，每隔21天或28天给药一次，初评(24个周期)总有效率为78%，其中完全缓解12例(29%)，部分缓解20例(49%)。延长治疗至68个疗程后，40%的PR进展，最终ORR为58%，CRS为31%。8名患者(2名CRS，6名PR)随后接受了同种异体移植。中位无进展生存期和总生存期分别超过11个月和21个月；完全应答者的中位无病生存期超过9个月，复发率仅为30%。结果与疾病化疗敏感性、既往移植和苯达莫司汀剂量强度无关。未发生危及生命或意想不到的不良事件。在回顾分析和计划异质性的范围内，这些结果似乎非常鼓舞人心，并促使前瞻性试验证实苯达莫司汀在同种异体移植前的姑息治疗和细胞减少策略中是一种有价值的选择。
The management of patients with Hodgkin lymphoma (HL) recurring after stem cell transplantation (SCT) and multiply relapsed disease remains challenging. We report on 41 such patients who received bendamustine hydrochloride, a bifunctional mechlorethamine derivative mechanistically unrelated to traditional alkylators, after a median of four prior chemotherapy lines, including SCT in 85% of cases. Bendamustine was given at doses of 90120 mg/m2 every 21 or 28 d. At first assessment (24 cycles), the overall response rate (ORR) was 78% with 12 (29%) complete (CR) and 20 (49%) partial responses (PR). Upon treatment prolongation to 68 courses, 40% of PRs progressed, yielding a final ORR of 58% with 31% of CRs. Eight patients (two CRs, six PRs) were subsequently allotransplanted. Median progression-free and overall survival exceeded 11 and 21 months respectively; complete responders displayed a median disease-free survival above 9 months with a relapse rate of only 30%. Outcomes were independent of disease chemosensitivity, previous transplant and bendamustine dose-intensity. No life-threatening or unexpected adverse events occurred. Within the limits of a retrospective analysis and schedule heterogeneity, these results appear very encouraging and prompt prospective trials to confirm bendamustine as a valuable option in the palliative setting and in cytoreductive strategies before allotransplantation.