Bendamustine plus rituximab for the treatment of Waldenström Macroglobulinemia: Patient outcomes and impact of bendamustine dosing

Suzanne O. Arulogun*, Duncan Brian, Harshita Goradia, Aaron Cooney, Tobias Menne, RayMun Koo, Aideen T. O'Neill, Josephine M. I. Vos, Guy Pratt, Deborah Turner, Kirsty Marshall, Kate Manos, Claire Anderson, Maria Gavriatopoulou, Charalampia Kyriakou, Marie J. Kersten, Monique C. Minnema, Eirini Koutoumanou, Dima el-Sharkawi, Kim LintonDipti Talaulikar, Helen McCarthy, Mark Bishton, George Follows, Ashutosh Wechalekar, Shirley P. D'Sa

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Bendamustine and rituximab (BR) therapy is commonly used in the treatment of Waldenström Macroglobulinemia (WM). The impact dose of Bendamustine dose on response and survival outcomes is not well-established, and the impact of its use in different treatment settings is not clear. We aimed to report response rates and survival outcomes following BR, and clarify the impact of depth of response and bendamustine dose on survival. A total of 250 WM patients treated with BR in the frontline or relapsed settings were included in this multicenter, retrospective cohort analysis. Rates of partial response (PR) or better differed significantly between the frontline and relapsed cohorts (91.4% vs 73.9%, respectively; p < 0.001). Depth of response impacted survival outcomes: two-year predicted PFS rates after achieving CR/VGPR vs PR were 96% versus 82%, respectively (p = 0.002). Total bendamustine dose was predictive of PFS: in the frontline setting, PFS was superior in the group receiving ≥1000 mg/m2 compared with those receiving 800–999 mg/m2 (p = 0.04). In the relapsed cohort, those who received doses of <600 mg/m2 had poorer PFS outcomes compared with those who received ≥600 mg/m2 (p = 0.02). Attaining CR/VGPR following BR results in superior survival, and total bendamustine dose significantly impacts response and survival outcomes, in both frontline and relapsed settings.
Original languageEnglish
Pages (from-to)750-759
Number of pages10
JournalAmerican Journal of Hematology
Issue number5
Early online date2023
Publication statusPublished - May 2023
Externally publishedYes

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