The safety of bendamustine in patients with chronic lymphocytic leukemia or non-Hodgkin lymphoma and concomitant renal impairment: a retrospective electronic medical record database analysis

• Published in: Leukemia & lymphoma 2014-06, Vol.55 (6), p.1266-1273
• Main Authors: Nordstrom, Beth L., Knopf, Kevin B., Teltsch, Dana Y., Engle, Robert, Beygi, Hooman, Sterchele, James A.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antineoplastic Agents, Alkylating - administration & dosage; Antineoplastic Agents, Alkylating - adverse effects; Antineoplastic Agents, Alkylating - therapeutic use; Bendamustine; Bendamustine Hydrochloride; chronic lymphocytic leukemia; Creatinine - urine; Databases, Factual; Female; Follow-Up Studies; Glomerular Filtration Rate; Humans; Leukemia, Lymphocytic, Chronic, B-Cell - complications; Leukemia, Lymphocytic, Chronic, B-Cell - diagnosis; Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy; Lymphoma, Non-Hodgkin - complications; Lymphoma, Non-Hodgkin - diagnosis; Lymphoma, Non-Hodgkin - drug therapy; Male; Middle Aged; Nitrogen Mustard Compounds - administration & dosage; Nitrogen Mustard Compounds - adverse effects; Nitrogen Mustard Compounds - therapeutic use; non-Hodgkin lymphoma; renal impairment; Renal Insufficiency - complications; retrospective; Retrospective Studies; Treatment Outcome
• ISSN: 1042-8194; 1029-2403
• DOI: 10.3109/10428194.2013.836600

Abstract This retrospective study compared adverse-event rates in patients with chronic lymphocytic leukemia (CLL) or non-Hodgkin lymphoma (NHL), with and without renal impairment, receiving bendamustine alone or with rituximab. Patients (n = 940) were stratified into a renally impaired group (creatinine clearance [CrCL] < 40 mL/min) and two comparator groups (CrCL ≥ 40 mL/min and CrCL ≥ 60 mL/min). Renally impaired patients with NHL had a significantly greater incidence of grade 3-4 thrombocytopenia compared with the CrCL ≥ 60 mL/min group (hazard ratio [HR], 2.57; p = 0.025). For CLL and NHL together, grade 3-4 increased blood urea nitrogen was significantly higher in the renally impaired group than in the CrCL ≥ 40 mL/min (HR, 2.36; p = 0.02) and CrCL ≥ 60 mL/min (HR, 4.46; p = 0.001) groups. Based on these results, monitoring blood counts (including platelets) and renal function would be prudent in the management of patients with renal dysfunction and NHL or CLL who receive bendamustine-based regimens.