Excellent response of rituximab and bendamustine in elderly patient with relapsed diffuse large B-cell lymphoma: a case report

Abstract

Rituximab in combination with cyclophosphamide, doxorubicin, vincristine,
and prednisone (R-CHOP) is currently the most widely used first-line therapy
for aggressive B-cell lymphomas. However, many patients, including those
with organ dysfunction, may not tolerate the toxicities associated with this
regimen. Recent data from the phase III study group indolent lymphomas
(StiL) non-Hodgkin lymphoma (NHL)-1 trial suggested that bendamustine plus
rituximab were superior in effectiveness and tolerability compared to R-CHOP
in the treatment of indolent and mantle cell lymphomas. Preliminary study
has indicated the effective use of bendamustine alone or in combination in
the treatment of aggressive B-cell lymphomas as well. A 70-year-old male
with heavily treated relapsed diffuse large B-cell lymphoma (DLBCL) showed
complete remission (CR) after receiving 8 cycles of rituximab in combination
with bendamustine as 3rd line treatment. Bendamustine has demonstrated
considerable efficacy and well-tolerated therapy in relapsed DLBCL patients.
Our case report demonstrated that treating patients with bendamustinebased
regimen, even in the setting of organ impairment and elderly is safe
and effective. Given the increasing evidence of its effectiveness, further
investigation of bendamustine’s safety and tolerability aspects in special
groups is recommended such as those with renal impairment.