Outcomes of our patients with hematological malignancies treated wi̇th bendamustine and rituximab

Aim: Non-Hodgkin Lymphomas are neoplastic diseases that originate from lymphoid tissues i.e. mainly lymph nodes. Treatment approaches of Non-Hodgkin lymphomas differ depending on clinical parameters such as tumor stage, phenotype (B, T or Natural Killer cell), histopathology (low, intermediate or high grade), patient's performance status, symptoms, age, and comorbidities. Anthracycline-based regimens in combination with rituximab have become the mainstay of treatment in CD20-positive NHLs. Bendamustine ± Rituximab (BR) treatment has been widely used since 2010s. In this study, we aimed to investigate the efficacy and safety data of BR chemotherapy regimen in patients with a diagnosis of NHL. Materials and Methods: In this study we have included 210 patients with a diagnosis of NHL who were referred to our Çukurova University Department of Hematology clinics between 2013 and 2023. Clinical and laboratory data of the patients as well as treatment responses were recorded with the data required from the digital archive system of our hospital. The primary endpoint of this study was to document treatment responses, efficacy and the safety of applied therapies. Results: In our study, subtypes of patients with a diagnosis of NHL were; DLBCL %13.8 (29), FL %9.5 (20), MZL %14.3 (30), MCL %11.4 (24), CLL %36.2 (76), WM %3.8 (8), %11.0 (23) unclassified indolent NHL. Of the total patients 109 (54.5%) had received BR and the rest of the patients had R-CHOP, R-CVP or similar regimens as the firstline treatment. As the secondline treatment 61% (71) of the patients had BR, 8.6% (10) had R-CHOP. The median age of the total group was 61.2±12.6, of which 89 (42%) were female. At diagnosis 20% (43) of the patients presented with B symptoms. Overall response rate for the NHL patients who received BR was 75.23% compared to 70% in patients who had R-CHOP as the firstline treatment (p>0.05). Five year overall survival was found signifiantly longer in patients with DLCL who had R-CHOP as the firstline therapy compared to those who received BR (p<0.05). Five-year PFS was not different between two groups with DLBCL. Patients who had R-CHOP as younger than patients who received BR (p=0.012). Survival outcomes were similar in patients with FL, MZL and MCL when both therapies were compared. Neutropenia was documented in 104 patients (55%) (86.5% with grade III neutropenia) who had BR. Within the R-CHOP group, neutropenia was observed in 13 patients (65%) and febrile neutropenia in 8 patients (40%). Conclusion: According to our data, R-CHOP therapy resulted in superior overall survival outcome compared to patients who received BR treatment as the firstline treatment in patients with DLBCL. However in elderly patients and those with significant comorbidities BR treatment is an effective alternative in all NHL subtypes with a similar adverse effect profile. Key Words: Bendamustine, Rituximab, Treatment, Non-Hodgkin Lymphoma