[Clinical analysis of bendamustine combined with rituximab as first-line therapy for B-cell lymphoproliferative disorders other than follicular lymphoma].

Abstract

This study aimed to evaluate the efficacy and safety of bendamustine combined with rituximab as first-line therapy in B-cell lymphoproliferative disorders (BLPD) other than follicular lymphoma (FL). Based on the Lymphoma Subcohort of the National Hematological Disease Cohort Study, a total of 91 newly diagnosed patients with non-FL BLPD receiving frontline bendamustine-rituximab regimen at the Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences from August 2019 to February 2025 were enrolled.The median age of the cohort was 59 years (range, 30 - 79 years), with a male-to-female ratio of 1.6:1 (56 males and 35 females). Among all subjects, 78 patients completed ≥ 2 cycles of induction therapy, with a best complete response (CR) rate of 59.0% and an objective response rate of 88.5%. The primary grade 3 - 4 hematological adverse events included neutropenia, lymphopenia, anemia and thrombocytopenia, while common non-hematological adverse events consisted of fever, infection and abnormal liver function. With a median follow-up duration of 41 months (range, 2 - 70 months), the 5-year progression-free survival (PFS) rate and 5-year overall survival (OS) rate were 78.1% (95% CI:50.3%-91.5%) and 85.2% (95% CI:56.8%-95.6%), respectively. Multivariate analysis identified age ≥60 years as an independent risk factor for PFS (HR=9.161, 95% CI: 1.063-78.960, P=0.044), and CR achievement as an independent protective factor for PFS (HR=0.087, 95% CI: 0.009-0.807, P=0.032). In conclusion, bendamustine combined with rituximab is an effective first-line treatment option for patients with non-FL BLPD.