Bendamustine hydrochloride in patients with B-cell malignancies who have comorbidities–is there an optimal dose?

Max J. Gordon, Lionel D. Lewis, Jennifer R. Brown, Alexey Danilov

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

Introduction: The majority of patients with non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL) present with comorbidities. Many of them are poor candidates for intensive chemo-immunotherapy regimens, such as FCR (fludarabine, cyclophosphamide, rituximab). Still, most clinical trials aim to enroll ‘fit’ patients, who poorly represent the community oncology population. Areas covered: In the past decade, bendamustine hydrochloride, a cytotoxic agent with structural similarities to both alkylating agents and purine analogs, has received widespread use in therapy of NHL and CLL, and has demonstrated a relatively favorable toxicity profile. However, bendamustine has not been well studied in patients with hematologic malignancies who have comorbidities. Here we review the clinical data on use of bendamustine in older and unfit patients with NHL and CLL, and analyze whether there is an optimal dose of bendamustine in patients who have significant comorbidities, including renal dysfunction. Expert commentary: Reduced intensity regimens of bendamustine are effective in CLL patients with comorbidities and renal dysfunction. Even with the introduction of targeted therapies, bendamustine will likely continue to be an important therapeutic option in patients with comorbidities because of its tolerability, efficacy and cost.

Original languageEnglish (US)
Pages (from-to)707-718
Number of pages12
JournalExpert Review of Hematology
Volume10
Issue number8
DOIs
StatePublished - Aug 3 2017

Fingerprint

B-Lymphocytes
Comorbidity
B-Cell Chronic Lymphocytic Leukemia
Neoplasms
Non-Hodgkin's Lymphoma
Kidney
Alkylating Agents
Cytotoxins
Hematologic Neoplasms
Bendamustine Hydrochloride
Immunotherapy
Cyclophosphamide
Therapeutics
Clinical Trials
Costs and Cost Analysis
Population

Keywords

  • Chronic lymphocytic leukemia (CLL)
  • cumulative illness risk scale (CIRS)
  • dose reduction
  • non-Hodgkin lymphoma (NHL)
  • renal insufficiency
  • therapy

ASJC Scopus subject areas

  • Hematology

Cite this

Bendamustine hydrochloride in patients with B-cell malignancies who have comorbidities–is there an optimal dose? / Gordon, Max J.; Lewis, Lionel D.; Brown, Jennifer R.; Danilov, Alexey.

In: Expert Review of Hematology, Vol. 10, No. 8, 03.08.2017, p. 707-718.

Research output: Contribution to journalReview article

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