Journal article
An international analysis evaluating frontline bendamustine with rituximab in extranodal marginal zone lymphoma
Blood advances, Vol.6(7), pp.2035-2044
04/12/2022
DOI: 10.1182/bloodadvances.2021006844
PMCID: PMC9006265
PMID: 35196377
Abstract
Extranodal marginal zone lymphoma (EMZL) is a heterogeneous non-Hodgkin lymphoma. No consensus exists regarding the standard-of-care in patients with advanced-stage disease. Current recommendations are largely adapted from follicular lymphoma, for which bendamustine with rituximab (BR) is an established approach. We analyzed the safety and efficacy of frontline BR in EMZL using a large international consortium. We included 237 patients with a median age of 63 years (range, 21-85). Most patients presented with Eastern Cooperative Oncology Group (ECOG) performance status 0 to 1 (n = 228; 96.2%), stage III/IV (n = 179; 75.5%), and intermediate (49.8%) or high (33.3%) Mucosa Associated Lymphoid Tissue International Prognosis Index (MALT-IPI). Patients received a median of 6 (range, 1-8) cycles of BR, and 20.3% (n = 48) received rituximab maintenance. Thirteen percent experienced infectious complications during BR therapy; herpes zoster (4%) was the most common. Overall response rate was 93.2% with 81% complete responses. Estimated 5-year progression-free survival (PFS) and overall survival (OS) were 80.5% (95% CI, 73.1% to 86%) and 89.6% (95% CI, 83.1% to 93.6%), respectively. MALT-IPI failed to predict outcomes. In the multivariable model, the presence of B symptoms was associated with shorter PFS. Rituximab maintenance was associated with longer PFS (hazard ratio = 0.16; 95% CI, 0.04-0.71; P = .016) but did not impact OS. BR is a highly effective upfront regimen in EMZL, providing durable remissions and overcoming known adverse prognosis factors. This regimen is associated with occurrence of herpes zoster; thus, prophylactic treatment may be considered.
Details
- Title: Subtitle
- An international analysis evaluating frontline bendamustine with rituximab in extranodal marginal zone lymphoma
- Creators
- Juan Pablo Alderuccio - University of MiamiLuca Arcaini - Policlinico San Matteo FondazioneMarcus P. Watkins - Washington University in St. LouisAnne W. Beaven - University of North Carolina at Chapel HillGeoffrey Shouse - City Of Hope National Medical CenterNarendranath Epperla - The Ohio State UniversityMichele Spina - Centro di Riferimento OncologicoAlexandra Stefanovic - Duke University HospitalJose Sandoval-Sus - Memorial Healthcare SystemPallawi Torka - Roswell Park Cancer InstituteAsh B. Alpert - Brown UniversityAdam J. Olszewski - Brown UniversitySeo-Hyun Kim - Rush University Medical CenterBrian Hess - Medical University of South CarolinaSameh Gaballa - Moffitt Cancer CenterSabarish Ayyappan - University of IowaJorge J. Castillo - Dana-Farber Cancer InstituteLisa Argnani - University of BolognaTimothy J. Voorhees - University of North Carolina at Chapel HillRaya Saba - Washington University in St. LouisSayan Mullick Chowdhury - The Ohio State UniversityFernando Vargas - Memorial Healthcare SystemIsildinha M. Reis - University of MiamiDeukwoo Kwon - University of MiamiJonathan S. Alexander - MUSC Hollings Cancer CenterWei Zhao - Sylvester Comprehensive Cancer CenterDali Edwards - 10Roswell Park Comprehensive Cancer Center, United StatesPeter Martin - Cornell UniversityEmanuele Cencini - Azienda Ospedaliera Universitaria SeneseManali Kamdar - University of Colorado DenverBrian K. Link - University of IowaConstantine N. Logothetis - Medical University of South CarolinaAlex F. Herrera - City Of Hope National Medical CenterJonathan W. Friedberg - University of RochesterBrad S. Kahl - Washington University in St. LouisStefano Luminari - University of Modena and Reggio EmiliaPier Luigi Zinzani - University of BolognaIzidore S. Lossos - University of Miami
- Resource Type
- Journal article
- Publication Details
- Blood advances, Vol.6(7), pp.2035-2044
- DOI
- 10.1182/bloodadvances.2021006844
- PMID
- 35196377
- PMCID
- PMC9006265
- NLM abbreviation
- Blood Adv
- ISSN
- 2473-9529
- eISSN
- 2473-9537
- Publisher
- Elsevier
- Number of pages
- 10
- Language
- English
- Date published
- 04/12/2022
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984359782702771
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