In a recent real-world efficacy study published in Cureus, researchers sought to assess the efficacy and safety of bendamustine-rituximab combination therapy (BR) as frontline therapy for indolent non-Hodgkin lymphoma (NHL).

This study included adults who received BR as frontline therapy for indolent NHL from January 2015 to August 2018.

The study cohort was comprised of 42 adults with an average age of 63 years. Follicular lymphoma was the most common histology (n = 31, 74%), and most patients had advanced disease (Lugano stage III or IV, 88%).

As per the protocol, patients received rituximab at the dose of 375 mg/m2 on Day 1 of each cycle. On Days 1 and 2, patients received an IV infusion of bendamustine at a standard dose of 90 mg/m2 or at a reduced dose of 60 mg/m2. Treatment was administered every 4 weeks and sustained for six cycles unless disease progression, histology transformation, unacceptable toxicity, or the patient’s refusal to continue therapy transpired.

The results revealed that the overall response rate was 84% (complete response = 62% and partial response = 22%), and median progression-free survival (PFS) was not achieved. At 30 months, PFS was 74.8% and overall survival was 90%. Grade 3-4 neutropenia occurred in 21% of patients.

Additionally, 17 patients (40%) experienced infection-related adverse events, most of which were grade 1 and 2 events (84%), and one case of grade 5 progressive multifocal leukoencephalopathy related to John Cunningham virus reactivation was detected. The most common noninfectious-related adverse events recorded included mild nausea and fatigue.

The authors concluded that compared with prior studies, the safety and efficacy of BR treatment for indolent lymphoma are comparable in a real-life cohort of patients, and their findings support the use of BR as a standard of care for indolent NHL.

The authors wrote, “Additional follow-up is warranted to determine long-term PFS and OS in our cohort. Future studies should assess whether the use of granulocyte-colony stimulating factor (G-CSF) as primary prophylaxis effectively mitigates the hematological and infectious adverse events related to BR therapy.”

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