Evaluating BCD chemotherapy for patients with peripheral T-cell lymphoma

This study evaluated the safety and effectiveness of BCD chemotherapy (bendamustine, carboplatin, and dexamethasone) for patients with peripheral T-cell lymphoma that has come back or stopped responding to treatment. This study concluded that this treatment was promising, with minimal side effects.

Peripheral T-cell lymphoma (PTCL) is an aggressive type of non-Hodgkin’s lymphoma. This type of cancer affects T lymphocytes (T-cells). These immune cells help fight infection. Treatment remains challenging for patients with PTCL that has come back or stopped responding to treatment.

High-dose chemotherapy followed by a stem cell transplant is one treatment option for these patients. However, 60 – 70% of these patients are not good candidates for a transplant. These patients need other treatment options. Previous studies have shown that bendamustine (Treanda) is effective for PTCL. Whether adding carboplatin (Paraplatin) and dexamethasone (Decadron) to bendamustine makes it more effective is unclear.

This study had 28 patients with PTCL that came back (43%) or stopped responding to treatment (57%). 43% of patients had failed 2 or 3 prior chemotherapy regimens. All patients received 2 cycles of BCD chemotherapy (bendamustine, carboplatin, dexamethasone). The average follow-up period was 20.5 months.

Overall, 54% of patients (15 patients) responded to treatment. 19% of patients had a complete disappearance of all signs of cancer. 35% of patients had tumor shrinkage. 5 out of these 15 patients then underwent a stem cell transplant. All of these patients had a complete disappearance of all signs of cancer after the transplant.

At follow-up, patients remained alive for an average of 4.4 months without tumor growth or spread. This was significantly higher for patients who had a stem cell transplant after chemotherapy (20.2 months).

Most side effects were mild. However, some patients reported serious side effects. The most common ones were low platelet count (cells involved in blood clotting; 39%) and low white blood cell count (18%). 28% of patients needed dose reductions of treatment due to side effects.

This study concluded that BCD chemotherapy showed promise in patients with recurrent or non-responsive PTCL, with minimal side effects. The authors suggest that more studies are needed to identify other agents that could be combined with bendamustine for these patients.

This study was very small. Also, this study involved Korean patients only, so these results may not apply to all patients. More studies with larger patient populations are needed to confirm these results.