Bendamustine and rituximab is well-tolerated and efficient in the treatment of indolent non-Hodgkin's lymphoma and mantle cell lymphoma in elderly: A single center observational study.

Autor: Kotchetkov R; Simcoe Muskoka Regional Cancer Program, Royal Victoria Regional Health Center, Barrie, Ontario, Canada., Drennan IR; Department of Family and Community Medicine, Temerity Faculty of Medicine, Sunnybrook Research Institute, Sunnybrook Health Science Center, University of Toronto, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada., Susman D; Western University, London, Ontario, Canada., DiMaria E; Simcoe Muskoka Regional Cancer Program, Royal Victoria Regional Health Center, Barrie, Ontario, Canada., Gerard L; Simcoe Muskoka Regional Cancer Program, Royal Victoria Regional Health Center, Barrie, Ontario, Canada., Nay D; Simcoe Muskoka Regional Cancer Program, Royal Victoria Regional Health Center, Barrie, Ontario, Canada., Prica A; Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: International journal of cancer [Int J Cancer] 2023 May 01; Vol. 152 (9), pp. 1884-1893. Date of Electronic Publication: 2022 Dec 30.
DOI: 10.1002/ijc.34412
Abstrakt: Bendamustine and rituximab (BR) is a preferred first-line therapy for indolent non-Hodgkin's lymphoma (iNHL) and mantle cell lymphoma (MCL); however, few reports on BR performance in elderly patients are available to date. We compared safety and efficacy of BR in patients ≥70 years (elderly) vs <70 years (younger) treated at our institution. Among 201 patients, 113 were elderly (median age: 77 years), including 38 patients ≥80 years, and 88 were younger (median age: 62 years). Elderly patients had more bone marrow involvement by lymphoma, anemia, ECOG status 3 and high-risk disease follicular lymphoma (P < .05 for all). Fifty-four percent of elderly received full dose of bendamustine vs 79.5% of younger patients. More elderly patients (54%) vs younger (43.2%) experienced treatment delay. Less elderly proceeded to rituximab maintenance. Overall, the number of adverse events per patient and transformed B-Cell lymphoma/secondary malignancies were similar between groups. Elderly patients had less febrile neutropenia, rituximab-associated infusion reactions, but more herpes zoster reactivation. There were more deaths in the elderly (37.2%) vs younger (10.2%) groups (P < .001), mainly due to non-lymphoma-related causes. With median follow-up of 42 months [4.0-97.0] disease-free survival for the elderly was similar to younger patients. There was no difference between patients <80 and ≥80 years (P = .274). In conclusion, the real-world elderly patients have more advanced disease and higher ECOG status. BR is well-tolerated; elderly patients had lower incidence of febrile neutropenia. Dose reduction and treatment delays are common, but BR efficacy was not affected even in very old patients (≥80 years).
(© 2022 UICC.)
Databáze: MEDLINE
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