Bendamustine and rituximab combination is safe and effective as salvage regimen in Waldenström macroglobulinemia

Leuk Lymphoma. 2015;56(9):2637-42. doi: 10.3109/10428194.2015.1012714. Epub 2015 Mar 14.


According to the European Society for Medical Oncology and National Comprehensive Cancer Network guidelines on Waldenström macroglobulinemia, bendamustine (B) may be considered a suitable therapeutic option. To address the role of B in combination with rituximab (BR), we analyzed the outcome of 71 patients with relapsed/refractory disease, median age 72 years, treated with R 375 mg/m(2) day 1 and B days 1 and 2 (dosage ranging from 50 to 90 mg/m(2)). Patients had previously received a median number of 2 lines of treatment (range 1-5). Overall and major response rates were 80.2% and 74.6%. Major toxicity was grade 3/4 neutropenia occurring in 13% of courses. There was no significant association between baseline features or patients' characteristics and response achievement. Median progression-free survival was not reached after a median follow-up of 19 months (range 3-54). None of the patients developed aggressive lymphoma or secondary myelodysplastic syndrome/acute myeloid leukemia. BR was found to be an active and well-tolerated salvage regimen leading to rapid disease control.

Keywords: Bendamustine; Waldenström macroglobulinemia; refractory; relapsed; rituximab; salvage.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bendamustine Hydrochloride / administration & dosage
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Retreatment
  • Retrospective Studies
  • Rituximab / administration & dosage
  • Salvage Therapy
  • Treatment Outcome
  • Waldenstrom Macroglobulinemia / diagnosis
  • Waldenstrom Macroglobulinemia / drug therapy*
  • Waldenstrom Macroglobulinemia / mortality


  • Rituximab
  • Bendamustine Hydrochloride