Bendamustine monotherapy in advanced and refractory chronic lymphocytic leukemia

摘要: Bendamustine, an alkylating agent without cross-resistance to cyclophosphamide is active in a variety of lymphoproliferative and other malignancies. In open phase-II study we treated 23 patients with median age 62 years at entry (43-86 years) advanced, refractory or relapsed (Rai stage III n = 9, Rai IV 14) chronic lymphocytic leukemia (CLL) bendamustine. At entry, only 13 were chemotherapy-naive. The treatment schedule bendamustine was as follows: for up 70 60 mg/m2 5 days, over 50 repetition day 29. Remission criteria used according Cheson et al. (1996). All evaluable toxicity 20 response. An objective remission achieved 15/20 (75%), including six complete (CR). Three the responders had no chemotherapy prior No change (NC) occurred 5/20 (25%). Median overall survival after 13.6 months (1-46 months) 16.6 responding total, 74 courses applied. Therapy-related anemia thrombocytopenia rare. However, WHO grade III/IV leukocytopenia 38/74 cycles (51%), resulting treatment-related mortality 3/23 (13%). These severely immunocompromised due pretreatment underlying disease. As corollary study, general prophylactic antibiotic (trimethoprim/ sulfamerazine) instituted. A feature decline CD4/CD8 ratio: mean before therapy: 1.36; two courses: 0.98; four 0.6, documented all who received least (n 12). showed CD4/8 ratio. this not clearly related increased risk infectious episodes. We observed mainly cutaneous allergic reactions (three I; one II) leading cessation 4/23 (18%). Bendamustine highly effective advanced CLL. multiple pretreated otherwise might lead additional immunosuppression subsequent complications.