Chronic Lymphocytic Leukemia Coverage from Every Angle

Bendamustine Plus Rituximab in Older Patients With CLL: Swedish Real-World Study

By: Lauren Harrison, MS
Posted: Tuesday, September 15, 2020

Treatment of chronic lymphocytic leukemia (CLL) with bendamustine plus rituximab is well established in patients between the ages of 66 and 70. According to a retrospective real-world report of nearly 150 Swedish patients, this regimen appears to have similar efficacy and safety in older patients as well. These conclusions were reported in the British Journal of Haematology by Lotta Hansson, MD, PhD, of Karolinska University Hospital, Stockholm, and colleagues.

The study focused on patients diagnosed with CLL between January 2007 and December 2016 from the Regional Cancer Registry in Stockholm. A total of 84 patients were treated with bendamustine and rituximab as first line, and 57 patients received the combination later. The median age of all patients at the start of treatment was 72 years. In addition, 16% of patients were older than 80.

Of the patients older than 80, 15% received full-dose bendamustine, whereas 65% postponed starting rituximab until the second cycle. In patients between the ages of 73 and 79, 21% received the full bendamustine dose, and 36% postponed the introduction of rituximab. The overall response rate was 83% among patients who received both agents in the first line, decreasing to 67% for patients who received them later. Complete responses were seen in 12% of patients receiving bendamustine and rituximab in the first line and 4% of those who received it later. Additionally, overall survival was significantly longer in those treated with this combination in the first line compared with those treated later.

Grade 3 or greater toxicity was seen in 23% of patients treated with bendamustine/rituximab in the first line and 14% of patients treated with the combination later. Common side effects were anemia, neutropenia, thrombocytopenia, renal failure, and skin toxicity. Death occurred in 33 patients. The cause of death was related to CLL in 61% of patients.

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