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First-line treatment with bendamustine and rituximab for old and frail patients with aggressive lymphoma: results of the B-R-ENDA trial

The incidence of aggressive B-cell lymphomas increases with age, but for elderly or frail patients not eligible for doxorubicin-containing treatment standard therapy remains to be defined. In this prospective, multicenter, phase-2 B-R-ENDA trial, we investigated the feasibility, toxicity, and effica...

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Main Authors: Braulke, Friederike (Author) , Zettl, Florian (Author) , Ziepert, Marita (Author) , Viardot, Andreas (Author) , Kahl, Christoph (Author) , Prange-Krex, Gabriele (Author) , Korfel, Agnieszka (Author) , Dreyling, Martin (Author) , Bott, Alexander (Author) , Wedding, Ulrich (Author) , Reichert, Dietmar (Author) , de Wit, Maike (Author) , Hartmann, Frank (Author) , Poeschel, Viola (Author) , Schmitz, Norbert (Author) , Witzens-Harig, Mathias (Author) , Klapper, Wolfram (Author) , Rosenwald, Andreas (Author) , Wulf, Gerald (Author) , Altmann, Bettina (Author) , Trümper, Lorenz (Author)
Format: Article (Journal)
Language:English
Published: Dec 1, 2022
In: HemaSphere
Year: 2022, Volume: 6, Issue: 12, Pages: 1-10
ISSN:2572-9241
DOI:10.1097/HS9.0000000000000808
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/HS9.0000000000000808
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/hemasphere/Fulltext/2022/12000/First_line_Treatment_With_Bendamustine_and.12.aspx
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Author Notes:Friederike Braulke, Florian Zettl, Marita Ziepert, Andreas Viardot, Christoph Kahl, Gabriele Prange-Krex, Agnieszka Korfel, Martin Dreyling, Alexander Bott, Ulrich Wedding, Dietmar Reichert, Maike de Wit, Frank Hartmann, Viola Poeschel, Norbert Schmitz, Mathias Witzens-Harig, Wolfram Klapper, Andreas Rosenwald, Gerald Wulf, Bettina Altmann, Lorenz Trümper
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Summary:The incidence of aggressive B-cell lymphomas increases with age, but for elderly or frail patients not eligible for doxorubicin-containing treatment standard therapy remains to be defined. In this prospective, multicenter, phase-2 B-R-ENDA trial, we investigated the feasibility, toxicity, and efficacy of 8 cycles rituximab combined with 6 cycles bendamustine (BR) in elderly or frail aggressive B-cell lymphoma patients: 39 patients aged >80 years and 29 patients aged 61-80 years with elevated Cumulative Illness Rating Scalescore >6 were included. Progression-free survival (PFS) and overall survival (OS) at 2 years were 45% (95% confidence interval [CI], 28%-61%) and 46% (28%-63%) for the patients age >80, as well 32% (13%-51%) and 37% (17%-57%) for frail patients age 64-80, respectively. In a preplanned retrospective analysis, we found no significant differences in PFS and OS comparing the outcome of the 39 patients age >80 years with 40 patients aged 76-80 years treated with 6xR-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) and 2 x rituximab in the RICOVER-60 trial (DSHNHL 1999-1, NCT00052936, EU-20243), yet we detected lower rates of infections and treatment-related deaths in the BR-treated patients. We demonstrate that older and frail patients with aggressive B-cell lymphoma who are not able to receive standard CHOP-based therapy can benefit from anthracycline-free therapy as a feasible and effective therapeutic option.
Item Description:Gesehen am 09.11.2023
Physical Description:Online Resource
ISSN:2572-9241
DOI:10.1097/HS9.0000000000000808

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