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

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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.

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Acknowledgments

This article did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

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Authors and Affiliations

  1. Department of Human Pathology, University of Messina, Via Consolare Valeria, 98125, Messina, Italy

    Patrizia Mondello & Vincenzo Pitini

  2. Department of Biological and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D’Alcontres n°31, 98166, Messina, Italy

    Patrizia Mondello & Salvatore Cuzzocrea

  3. Lymphoma Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box 330, New York, NY, 10065, USA

    Patrizia Mondello

  4. Internal Medicine V: Hematology & Oncology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria

    Normann Steiner, Wolfgang Willenbacher, Ines Wasle & Michael Mian

  5. Hematology, DISM, AOUD S. M. Misericordia, Piazzale Santa Maria della Misericordia, 33100, Udine, Italy

    Francesco Zaja

  6. Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Via 8 Febbraio 1848, 35122, Padova, Italy

    Renato Zambello & Andrea Visentin

  7. Department of Internal Medicine, Pordenone General Hospital, Via Montereale, 33170, Pordenone, Italy

    Endri Mauro

  8. Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, via Nizza 52, 10126, Turin, Italy

    Simone Ferrero & Paola Ghione

  9. Department of Hematology & CBMT, Ospedale di Bolzano, Via Lorenz Böhler, 5, Bolzano, Italy

    Michael Mian

Authors
  1. Patrizia Mondello
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  2. Normann Steiner
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  3. Wolfgang Willenbacher
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  4. Ines Wasle
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  5. Francesco Zaja
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  6. Renato Zambello
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  7. Andrea Visentin
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  8. Endri Mauro
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  9. Simone Ferrero
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  10. Paola Ghione
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  11. Vincenzo Pitini
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  12. Salvatore Cuzzocrea
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  13. Michael Mian
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Corresponding author

Correspondence to Patrizia Mondello.

Ethics declarations

This analysis was approved by the local Ethical Committee (Prot. 0042654-BZ). Due to the retrospective and anonymous data collection, informed consent was not necessary.

Conflict of interest

The authors have no conflicts of interest. PM, NS, IW, FZ, RZ, AV, EM, PG, VP, and SC have no financial disclosure. SF and MM have received honoraria from Mundipharma; WW has received honoraria and research funding from Mundipharma and Roche.

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Mondello, P., Steiner, N., Willenbacher, W. et al. Bendamustine plus rituximab versus R-CHOP as first-line treatment for patients with indolent non-Hodgkin’s lymphoma: evidence from a multicenter, retrospective study. Ann Hematol 95, 1107–1114 (2016). https://doi.org/10.1007/s00277-016-2668-0

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  • DOI: https://doi.org/10.1007/s00277-016-2668-0

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