Blood Res.  2018 Sep;53(3):223-226. 10.5045/br.2018.53.3.223.

Bendamustine, etoposide, and dexamethasone to mobilize peripheral blood hematopoietic stem cells for autologous transplantation in non-Hodgkin lymphoma

Affiliations
  • 1Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. agreenba@fredhutch.org
  • 2Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA.

Abstract

BACKGROUND
Bendamustine is a chemotherapeutic agent that has shown broad activity in patients with lymphoid malignancies. It contains both alkylating and nucleoside analog moieties, and thus, is not commonly used for stem cell mobilization due to concerns that it may adversely affect stem cell collection. Here we describe the lymphoma subset of a prospective, non-randomized phase II study of bendamustine, etoposide, and dexamethasone (BED) as a mobilization agent for lymphoid malignancies.
METHODS
This subset analysis includes diffuse large B-cell lymphoma (N=3), follicular lymphoma (N=1), primary mediastinal B-cell lymphoma (N=1), and NK/T-cell lymphoma (N=1). Patients received bendamustine (120 mg/m² IV d 1, 2), etoposide (200 mg/m² IV d 1-3), and dexamethasone (40 mg PO d 1-4) followed by filgrastim (10 mcg/kg/d sc. through collection).
RESULTS
We successfully collected stem cells from all patients, with a median of 7.9×10⁶/kg of body weight (range, 4.4 to 17.3×10⁶/kg) over a median of 1.5 days (range, 1 to 3) of apheresis. All patients who received transplants were engrafted using kinetics that were comparable to those of other mobilization regimens. Three non-hematologic significant adverse events were observed in one patient, and included bacterial sepsis (grade 3), tumor lysis syndrome (grade 3), and disease progression (grade 5).
CONCLUSION
For non-Hodgkin lymphoma, mobilization with bendamustine is safe and effective.

Keyword

Bendamustine; Stem cell mobilization; Non-Hodgkin lymphoma

MeSH Terms

Autografts*
Bendamustine Hydrochloride*
Blood Component Removal
Body Weight
Dexamethasone*
Disease Progression
Etoposide*
Filgrastim
Hematopoietic Stem Cell Mobilization
Hematopoietic Stem Cells*
Humans
Kinetics
Lymphoma
Lymphoma, B-Cell
Lymphoma, Follicular
Lymphoma, Non-Hodgkin*
Prospective Studies
Sepsis
Stem Cells
Transplantation, Autologous*
Tumor Lysis Syndrome
Bendamustine Hydrochloride
Dexamethasone
Etoposide
Filgrastim
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