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Chronic Leukemia

Bendamustine added to allogeneic conditioning improves long-term outcomes in patients with CLL

Bone Marrow Transplantation volume 52, pages 28–33 (2017)Cite this article

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Abstract

Bendamustine has shown a favorable safety profile when included in chemotherapy regimens for several types of lymphoma, including CLL. This study investigated the long-term effect of adding bendamustine to a conditioning regimen on survival, rate of engraftment, immune recovery and GvHD after allogeneic stem cell transplantation (alloSCT) in CLL patients. These outcomes were compared with the fludarabine, cyclophosphamide and rituximab (FCR) conditioning regimen. We reviewed the data for 89 CLL patients treated on three trials at our institution. Twenty-six (29%) patients received bendamustine, fludarabine and rituximab (BFR) and 63 (71%) received FCR. Patient characteristics were similar in both groups. Ten (38%) BFR-treated patients vs only two (3%) FCR-treated patients did not experience severe neutropenia (P=<0.001). The 3-year overall survival estimates for the BFR and FCR groups were 82 and 51% (P=0.03), and the 3-year PFS estimates were 63% and 27% (P=0.001), respectively. The 2-year treatment-related mortality was 8 and 23% and the incidence of grade 3 or 4 GvHD was 4% and 10%, respectively. This study is the first to report that addition of bendamustine to alloSCT conditioning for CLL patients is associated with improved survival and lower mortality, myelosuppression, and GvHD.

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Acknowledgements

We thank Diane Hackett and Christopher Graber from the Department of Scientific Publications at MD Anderson Cancer Center for editing this manuscript. Supported by the NIH/NCI under award number P30CA016672.

Author contributions

Conception and design by IFK, RLB Jr and AMG. Collection and assembly of data by IFK, DS, CL and RLB Jr. Data analysis and interpretation by IFK, DS, EJ, BIS, FT, GA, PA, SA, BO, SOC, DM, AO, KP, URP, CL, TMK, AF, JAB, JLJ, LJM, RLB Jr and AMG. Manuscript writing and final approval of manuscript by all authors.

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Authors and Affiliations

  1. Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    I F Khouri, G Alatrash, P Anderlini, S Ahmed, B Oran, S O Ciurea, D Marin, A Olson, K K Patel, U R Popat & C Ledesma

  2. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    D Sui & R L Bassett

  3. Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    E J Jabbour, T M Kadia, A Ferrajoli & J A Burger

  4. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    B I Samuels

  5. Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    F Turturro

  6. Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    J L Jorgensen & L J Medeiros

  7. The Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    A M Gulbis

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  1. I F Khouri
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  21. R L Bassett
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Corresponding author

Correspondence to I F Khouri.

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Khouri, I., Sui, D., Jabbour, E. et al. Bendamustine added to allogeneic conditioning improves long-term outcomes in patients with CLL. Bone Marrow Transplant 52, 28–33 (2017). https://doi.org/10.1038/bmt.2016.204

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  • DOI: https://doi.org/10.1038/bmt.2016.204

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