Turk J Haematol 2017 Mar 8
Clinical Outcomes Related to the Use of Bendamustine Therapy for Multiple Myeloma Patients Relapsed-Refractory to IMiDs and Proteasome Inhibitors.
Yalnız FF, Akkoç N, Salihoğlu A, Ar MC, Aydın S, Eşkazan AE, Soysal T, Aydın Y.
Multiple myeloma (MM) patients who are relapsed or refractory to both proteasome inhibitory (PIs) and immunomodulatory drugs (IMiDs) have been reported to have poor outcome. Bendamustine has been reported to have an antitumor effect in newly diagnosed as well as relapsed refractory multiple myeloma (RRMM). The aim of this retrospective study was to evaluate the efficacy of bendamustine therapy in heavily pretreated MM patients, who were refractory to PIs and IMiDs. Nineteen RRMM patients treated either with bendamustine and steroid (n=13) or a combination of bendamustine in with novel drugs (n=6) were included. Median number of previous treatment lines was 5 (range, 3-8) and median time from diagnosis was 6 years (range, 1-16). All of the patients were resistant to at least one of the IMiDs and one of the PIs. Bendamustine was given at doses ranging from 90mg/m2 to 120mg/m2 on days 1 and 2 of 28-day cycles. A median of 2 (range, 1-8) treatment cycles was administered per patient. Toxicity of bendamustine was mild and mostly of hematological origin. No complete remission was achieved. There was partial remission and stable disease in 21% and 11% of patients, respectively. Sixty-eight percent of cases had progressive disease. The median progression free survival and overall survival was 2 and 4 months, respectively. In conclusion, bendamustine therapy was well tolerated but showed limited anti-myeloma activity in heavily pretreated patients who were refractory to immunomodulatory agents and proteasome inhibitors.
iple myeloma (MM) patients who are relapsed or refractory to both proteasome inhibitory (PIs) and immunomodulatory drugs (IMiDs) have been reported to have poor outcome. Bendamustine has been reported to have an antitumor effect in newly diagnosed as well as relapsed refractory multiple myeloma (RRMM). The aim of this retrospective study was to evaluate the efficacy of bendamustine therapy in heavily pretreated MM patients, who were refractory to PIs and IMiDs. Nineteen RRMM patients treated either with bendamustine and steroid (n=13) or a combination of bendamustine in with novel drugs (n=6) were included. Median number of previous treatment lines was 5 (range, 3-8) and median time from diagnosis was 6 years (range, 1-16). All of the patients were resistant to at least one of the IMiDs and one of the PIs. Bendamustine was given at doses ranging from 90mg/m2 to 120mg/m2 on days 1 and 2 of 28-day cycles. A median of 2 (range, 1-8) treatment cycles was administered per patient. Toxicity of bendamustine was mild and mostly of hematological origin. No complete remission was achieved. There was partial remission and stable disease in 21% and 11% of patients, respectively. Sixty-eight percent of cases had progressive disease. The median progression free survival and overall survival was 2 and 4 months, respectively. In conclusion, bendamustine therapy was well tolerated but showed limited anti-myeloma activity in heavily pretreated patients who were refractory to immunomodulatory agents and proteasome inhibitors.