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Posted by on Oct 19, 2017 in Non-Hodgkin lymphoma | 0 comments

In a nutshell

This study looked at the safety and effectiveness of rituximab (Rituxan), bendamustine (Treanda), and low-dose cytarabine (Cytosar) for treating elderly patients with mantle cell lymphoma. The study concluded that this treatment is effective at treating elderly patients with mantle cell lymphoma, but has some adverse events. 

Some background

Mantle cell lymphoma (MCL) is an aggressive type of non-Hodgkin lymphoma. Patients are often treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone). However, patient outcomes could still be improved.

Rituximab, bendamustine¸ and cytarabine (R-BAC) has been more effective, but has too many negative side effects to become the standard of care. Some studies suggest that using low-dose cytarabine may be effective. More research is needed to determine if rituximab, bendamustine, and low-dose cytarabine (RBAC500) is an effective and safe treatment for MCL. 

Methods & findings

57 patients were recruited for the study. All patients were over 65 years old. Patients received RBAC500 every 4 weeks for up to 6 cycles. Cytarabine was given at a reduced dose of 500 mg/m2. The average length of follow up was 35 months.

Three patients discontinued due to toxicity, so 54 patients were included in the final analysis. 67% of patients completed 6 cycles. 72% of patients reduced their treatment dose at least once.

91% of patients achieved a complete response (no detectable cancer) at the end of treatment. The 2-year overall survival rate (time from treatment to death from any cause) was 86%.

No treatment-related deaths were recorded. 40% of patients experienceed side effects. 11% of patients had a grade 3 or 4 infection or viral reaction. 

The bottom line

The authors concluded that RBAC500 is an effective treatment for elderly patients with mantle cell lymphoma, but still has some safety issues. 

What’s next?

Talk to your doctor about whether RBAC500 treatment is right for you. RBAC500 may be more effective than other first line therapies, but it also may have more side effects. The risks must be weighed against the benefits for each individual patient. 

Published By :

The Lancet. Haematology

Date :

Jan 01, 2017

Original Title :

Rituximab, bendamustine, and low-dose cytarabine as induction therapy in elderly patients with mantle cell lymphoma: a multicentre, phase 2 trial from Fondazione Italiana Linfomi.

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