Bendamustine + rituximab chemoimmunotherapy and maintenance lenalidomide in relapsed, refractory chronic lymphocytic leukaemia and small lymphocytic lymphoma: A Wisconsin Oncology Network Study

Julie E. Chang, Thomas Havighurst, Kyungmann Kim, Jens Eickhoff, Anne M. Traynor, Rachel Kirby-Slimp, Lynn M. Volk, Jae Werndli, Ronald S. Go, Matthias Weiss, Jules Blank, Brad S. Kahl

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Bendamustine + rituximab (BR) has demonstrated high response rates in relapsed/refractory (R/R) chronic lymphocytic leukaemia (CLL) and small lymphocytic lymphoma (SLL). However, progression-free survival (PFS) after BR is <18 months. This study was designed to determine if maintenance lenalidomide after BR induction could improve PFS in R/R CLL/SLL. Thirty-four patients with R/R CLL/SLL who had received 1-5 prior chemotherapy regimens were treated with 6 cycles of BR induction. Patients achieving at least a minor response received twelve 28-d cycles of lenalidomide 5-10 mg/d. The primary endpoint was PFS. The median age was 67 years, with a median of 2 prior therapies. Eleven patients had confirmed presence of 17p and/or 11q deletions. Twenty-five (74%) completed 6 cycles of induction BR (response rate 56%). Nineteen (56%) patients received maintenance lenalidomide; only 6 patients completed the intended 12 cycles, highlighting the limited feasibility of lenalidomide in this setting, primarily due to haematological and infectious toxicities. The observed median PFS of 18·3 months is not significantly different from that of BR induction in R/R CLL/SLL without maintenance therapy (15·2 months). It is possible that lenalidomide maintenance may be more feasible and effective in the front-line setting, which is being tested in an ongoing trial (NCT01754857).

Original languageEnglish (US)
Pages (from-to)283-291
Number of pages9
JournalBritish journal of haematology
Volume173
Issue number2
DOIs
StatePublished - Apr 1 2016

Keywords

  • Bendamustine
  • Chronic lymphocytic leukaemia
  • Lenalidomide
  • Maintenance
  • Rituximab
  • Small lymphocytic lymphoma

ASJC Scopus subject areas

  • Hematology

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    Chang, J. E., Havighurst, T., Kim, K., Eickhoff, J., Traynor, A. M., Kirby-Slimp, R., Volk, L. M., Werndli, J., Go, R. S., Weiss, M., Blank, J., & Kahl, B. S. (2016). Bendamustine + rituximab chemoimmunotherapy and maintenance lenalidomide in relapsed, refractory chronic lymphocytic leukaemia and small lymphocytic lymphoma: A Wisconsin Oncology Network Study. British journal of haematology, 173(2), 283-291. https://doi.org/10.1111/bjh.13957