Combination of bendamustine and rituximab in the management of relapsed and refractory chronic lymphocytic leukemia: the results of retrospective study

Abstract

Efficacy and safety results of rituximab and bendamustine combination (Scheme BR) in patients with relapsed and refractory chronic lymphocytic leukemia (CLL) are presented. From 01.2012 to 04.2013, the treatment was initiated in 43 patients (21 with relapses are sensitive to the last line of therapy; 22 – with refractory CLL). Median age at start of therapy was 63.5 years (range from 43 to 81 years). In 40 patients response was evaluated according to NCI-WG criteria (1996). Complete remission (CR) is documented in 5 (12.5 %) cases, partial (PR) or nodular partial remission (nPR) in 17 (42.5 %) cases. MRD-negative CR was achieved in 1 (20.0 %) of 5 patients with CR. With 23.5 months of median follow-up for surviving patients 2-year progression-free survival (PFS) was 47.2 ± 8.5 % (median – 18.5 months), overall survival (OS) – 66.9 ± 7.9 % (median not achieved). Hematological toxicity Grade 3–4 occurred in 15 (34.9 %) cases, same degree infectious complicationsin 5 (11.6 %) cases. Patients received 3 or more therapy lines before this treatment (37.5 ± 16.1 % against 74.7 ± 8.3 %; p = 0.016), with «bulky disease» more than 10 cm (0.0 % vs. 75.4 ± 7.5 %; p < 0.001) and received rituximab in combination with chemotherapy in the previous lines, compared to the «naive» cases (44.1 ± 10.5 % against 92.9 ± 6.9 %; p = 0.009) have significantly worsened 2-year OS.

Keywords

• chronic lymphocytic leukemia
• relapse
• refractory
• bendamustine
• rituximab