Annals of Hematology

, Volume 95, Issue 7, pp 1107–1114 | Cite as

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

  • Patrizia Mondello
  • Normann Steiner
  • Wolfgang Willenbacher
  • Ines Wasle
  • Francesco Zaja
  • Renato Zambello
  • Andrea Visentin
  • Endri Mauro
  • Simone Ferrero
  • Paola Ghione
  • Vincenzo Pitini
  • Salvatore Cuzzocrea
  • Michael Mian
Original Article

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 R-CHOP Indolent lymphoma First-line therapy Follicular lymphoma 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Patrizia Mondello
    • 1
    • 2
    • 3
  • Normann Steiner
    • 4
  • Wolfgang Willenbacher
    • 4
  • Ines Wasle
    • 4
  • Francesco Zaja
    • 5
  • Renato Zambello
    • 6
  • Andrea Visentin
    • 6
  • Endri Mauro
    • 7
  • Simone Ferrero
    • 8
  • Paola Ghione
    • 8
  • Vincenzo Pitini
    • 1
  • Salvatore Cuzzocrea
    • 2
  • Michael Mian
    • 4
    • 9
  1. 1.Department of Human PathologyUniversity of MessinaMessinaItaly
  2. 2.Department of Biological and Environmental SciencesUniversity of MessinaMessinaItaly
  3. 3.Lymphoma ServiceMemorial Sloan Kettering Cancer CenterNew YorkUSA
  4. 4.Internal Medicine V: Hematology & OncologyMedical University of InnsbruckInnsbruckAustria
  5. 5.Hematology, DISM, AOUD S. M. MisericordiaUdineItaly
  6. 6.Hematology and Clinical Immunology Unit, Department of MedicineUniversity of PadovaPadovaItaly
  7. 7.Department of Internal MedicinePordenone General HospitalPordenoneItaly
  8. 8.Division of Hematology, Department of Molecular Biotechnologies and Health SciencesUniversity of TorinoTurinItaly
  9. 9.Department of Hematology & CBMTOspedale di BolzanoBolzanoItaly

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