Gemcitabine-based and/or bendamustine-based therapy efficacy in patients with lymphoma

Lymphomas are a group of diseases arising from the clonal proliferation of lymphocytes. Its incidence is increasing all over the world. It is divided into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Excisional biopsy is required for diagnosis. Treatment depends on the histological type, stage and prognostic factors of the lymphoma. Gemcitabine is a cytidine analogue. Effective in relapsed/refractory HL and NHL. Bendamustine belongs to the group of alkylating agents. It is indicated in chronic lymphocytic leukemia, multiple miyeloma, HL, diffuse large B cell lymphoma (DBBHL), follicular lymphoma (FL), marginal zone lymphoma (MZL). The aim of our study is to investigate the effectiveness of gemcitabine-based and/or bendamustine-based treatment in patients with lymphoma. Forty-four patients diagnosed with lymphoma who received gemcitabine-based and/or bendamustine-based treatment in the Department of Hematology, Faculty of Medicine, Fırat University were included in the study. Patients were divided into two groups as NHL and HL. İnvestigated retrospectively in which group the given treatments were more effective, how the indolent or aggressive subtype of patients with NHL changed the response to treatment and its effect on progression-free survival. Chi-square analysis (Pearson Chi-square), Shapiro Wilk test, student t test, Kaplan-Meier analysis, Log Rank (Mantel-Cox) analysis and SPSS 22 package program were used in the analysis of the data. Significance level was taken as p<0,05. In the study, 38 of the patients were diagnosed with NHL and 6 of them were diagnosed with HL. Of the patients, 15 (34,1%) received gemcitabine-based treatment and 29 (65,9%) received bendamustine-based treatment. The overall response rate was 20% in patients receiving gemcitabine-based therapy and 51,7% in patients receiving bendamustine-based therapy. The overall response rate was 28% in patients with NHL with an aggressive course, and 53,8% in patients with an indolent course. Progression was seen in 17 of 44 patients included in our study and the progression-free survival rate was 61,4%. When all patients were evaluated together, the mean progression-free survival time was found to be 182,8 months. As a result among the patients who received gemcitabine-based treatment, the response to treatment was found to be more effective in those with HL (p=0,013). Response to treatment could not be evaluated in patients receiving bendamustine-based treatment, due to the insufficient number of HL patients between the NHL and HL diagnosis groups. In NHL patients, there was no significant difference between being aggressive or indolent in terms of response to treatment (p=0,167). Keywords: Lymphomas, gemcitabine-based therapy, bendamustine-based therapy