Clinical Research Papers:
Bendamustine for the treatment of relapsed or refractory peripheral T cell lymphomas: A French retrospective multicenter study
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Abstract
Emilie Reboursiere1, Fabien Le Bras2, Charles Herbaux3, Emmanuel Gyan4, Aline Clavert5, Franck Morschhauser3, Sandra Malak6, David Sibon7, Florence Broussais8, Thorsten Braun9, Luc-Matthieu Fornecker10, Reda Garidi11, Sabine Tricot12, Roch Houot13, Bertrand Joly14, Wajed Abarah15, Bachra Choufi16, Anne-Dominique Pham17, Anne-Claire Gac1, Christophe Fruchart1, Emilie Marin1, Violaine Safar18, Anne Parcelier19, Hervé Maisonneuve20, Emmanuel Bachy21, Guillaume Cartron22, Arnaud Jaccard23, Olivier Tournilhac24, Cédric Rossi25, Luciane Schirmer26, Jean-Alain Martignoles27, Philippe Gaulard28, Hervé Tilly29, Gandhi Damaj1,30 and From the Lymphoma Study Association (LYSA) centers30
1 Department of Hematology, University Hospital of Caen, Caen, France
2 Department of Hematology, Assistance Publique des Hôpitaux de Paris, Créteil, France.
3 Department of Hematology, University and Regional Hospital of Lille, Lille, France
4 Department of Hematology, University Hospital of Tours, UMR CNRS, Tours, France
5 Department of Hematology, University Hospital of Angers, Angers, France
6 Department of Hematology, Institut Curie, Paris, France
7 Department of Hematology, Hôpital Necker-Enfants Malades, Paris, France
8 Department of Hematology, Institut Paoli Calmettes, Marseille, France
9 Department of Hematology, Hôpital Avicenne, Bobigny, France
10 Department of Hematology, University Hospital of Strasbourg, Strasbourg, France
11 Department of Hematology, Saint Quentin Hospital, Saint Quentin, France
12 Department of Hematology, Centre Hospitalier Valenciennes, Valenciennes, France
13 Department of Hematology, University Hospital Pontchaillot, Rennes, France
14 Department of Hematology, Centre Hospitalier Sud Francilien, Corbeil, France
15 Department of Hematology, Meaux Hospital, Meaux, France
16 Department of Hematology, Boulogne-sur-Mer Hospital, Boulogne-sur-Mer, France
17 Department of Biostatistics and Clinical Research, University Hospital of Caen, Caen, France
18 Department of Hematology, Hospices Civils de Lyon, Pierre-Benite, France
19 Department of Hematology, University Hospital of Amiens, Amiens, France
20 Department of Hematology, La Roche-sur-Yon Hospital, La Roche sur-Yon, France
21 Department of Hematology, Hospices Civils de Lyon, Pierre-Benite, France
22 Department of Hematology, Université Montpellier, CHRU, UMR CNRS, Montpellier, France
23 Department of Hematology, University Hospital of Limoges, Limoges, France
24 Department of Hematology, University Hospital of Clermont-Ferrand, Clermont Ferrand, France
25 Department of Hematology, University Hospital of Dijon, Dijon, France
26 Department of Hematology, University Hospital of Nancy, Vandoeuvre Les Nancy, France
27 Department of Hematology, Institut de Cancérologie Lucien Neuwirth, Saint-Etienne, France
28 Department of Pathology, University Paris Est, Hôpital Henri Mondor, Créteil, France
29 Department of Hematology, Centre Henri Becquerel, Rouen, France
30 Microenvironnement Cellulaire et Pathologies, Normandie University, UNICAEN, MILPAT, Caen, France
Correspondence to:
Gandhi Damaj, email:
Keywords: peripheral T cell lymphoma, bendamustine, efficacy, safety
Received: April 06, 2016 Accepted: July 10, 2016 Published: July 21, 2016
Abstract
Peripheral T-cell lymphoma (PTCL) is a group of diseases with poor outcome and few therapeutic options. We aimed to assess the efficacy of bendamustine in real life cohort of patients.
Between November 2009 and March 2015, 138 PTCL patients were treated with bendamustine in 27 centers. Population median age was 64 (28-89) years with male/female ratio of 1.4. There were mainly angio-immunoblastic (AITL = 71), PTCL-not otherwise specified (PTCL-NOS = 40) and anaplastic large cell lymphoma (ALCL = 8). The majority of patients (96%) had disseminated disease and extranodal localizations (77%). Median number of chemotherapy lines prior to bendamustine was 2 (1-8). Median duration of response (DoR) after the last chemotherapy prior to bendamustine was 4.3 months (1-70) and 50% of patients had refractory disease.
Median number of administered bendamustine cycles was 2 (1-8) and 72 patients (52%) received less than 3 mostly because of disease progression. Median dose was 90 (50-150) mg/m². Overall response rate (ORR) was 32.6% with complete response (CR) rate of 24.6% and median DoR was 3.3 months (1-39). AITL patients were more sensitive than PTCL-NOS patients (ORR: 45.1 versus 20%, p = 0.01). Median PFS and OS were 3.1 (0.2-46.3) and 4.4 (0.2-55.4) months. On multivariate analysis, refractory disease (p = 0.001) and extranodal localization (p = 0.028) adversely influenced ORR. Grade 3-4 thrombocytopenia, neutropenia and infections were reported in 22, 17 and 23% of cases respectively.
Bendamustine as single agent could be considered as a therapeutic option for relapsed or refractory PTCL, particularly in chemosensitive or AITL patients. Combinations of bendamustine with other drugs warrant further evaluation.
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