Evaluating RBD chemotherapy for recurrent or non-responsive non-Hodgkin lymphoma

This study evaluated how safe and effective RBD (rituximab, bendamustine, and dexamethasone) chemotherapy was for patients with B-cell non-Hodgkin lymphoma (NHL). This study concluded that this new regimen showed promising effectiveness for these patients.

Chemoimmunotherapy remains the standard first-line treatment for patients with B-cell NHL. This type of treatment combines chemotherapy with immunotherapy. While most patients respond to treatment, relapse (cancer recurrence) is common. Many patients also develop tumors that no longer respond to treatment (refractory).

The most common chemoimmunotherapy regimens contain a drug called rituximab (Rituxan). Rituximab is a monoclonal antibody. This type of treatment targets cancer cells and blocks their growth. This leads to cancer cell death. Combining rituximab with other anti-cancer drugs such as bendamustine (Treanda) has been effective for treating B-cell NHL. Whether adding dexamethasone (Decadron; a corticosteroid drug) to this combination is also effective for B-cell NHL is unclear.

This study had 33 patients with relapsed or refractory NHL. All patients received 6 cycles of RBD chemotherapy. Patients were divided into two groups based on the dose of dexamethasone (Decadron). 15 patients received a low dose (10mg/body) of dexamethasone while 18 patients received a high dose (20mg/body). Patients were followed-up for an average of 37 months.

Overall, 88% of patients responded to treatment. 58% of patients had a complete disappearance of all signs of cancer (complete response). 30% of patients had tumor shrinkage (partial response). Overall, 85.5% of patients were still alive 3 years later, with 75.5% of patients not having tumor growth or spread.

The most common side effects were cytomegalovirus (CMV) infection (33%) and rash (30%). CMV is a type of virus that can be life-threatening in individuals with weakened immune systems, such as patients treated with chemotherapy. Significantly more patients treated with a high dose of dexamethasone developed CMV compared to patients treated with a low dose (5 patients vs. 0 patients).

Serious side effects were also reported. 55% of patients had severely low white blood cell count. Neutrophils and lymphocytes are two important kinds of white blood cells. These cells help fight infections in the body and attack cancer cells. 67% of patients had severely low neutrophil count and 91% of patients had severely low lymphocyte count. 12% of patients also reported serious rash.

This study concluded that the RBD chemotherapy regimen showed promising effectiveness for patients with relapsed or refractory NHL.

This was a very small study. Larger studies are needed to confirm these results.