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1505 Bendamustine Treatment in Refractory or Relapsed T Cell Lymphomas: A Retrospective Multicenter Study

Lymphoma: Chemotherapy, excluding Pre-Clinical Models
Program: Oral and Poster Abstracts
Session: 623. Lymphoma: Chemotherapy, excluding Pre-Clinical Models: Poster I
Saturday, December 5, 2015, 5:30 PM-7:30 PM
Hall A, Level 2 (Orange County Convention Center)

Emilie Reboursiere1*, Fabien Le Bras2*, Franck Morschhauser, MD3*, Emmanuel Gyan, MD, PhD4, Aline Clavert, MD5*, Sandra Malak6*, David Sibon, MD7,8*, Marion Damge9*, Claude Gardin10*, Luc-Matthieu Fornecker11*, Reda Garidi12*, Sabine Tricot13*, Roch Houot14*, Bertrand Joly, MD15*, Wajed Abarah, MD16*, Bachra Choufi, MD17*, Anne-dominique Pham1*, Sylvain P Chantepie, MD18*, Christophe Fruchart, MD19*, Anne-Claire Gac1*, Catherine Ollivier20,21*, Emilie Marin1*, Violaine Safar22*, Anne Parcelier, MD23,24*, Herve Maisonneuve, MD25*, Emmanuel Bachy26,27*, Guillaume Cartron, MD, PhD28*, Arnaud Jaccard, MD, PhD29*, Olivier Tournilhac30*, Cedric Rossi, MD31*, Aurore Perrot32*, Jean-Alain Martignoles33*, Herve Tilly, MD, PhD34 and Gandhi Damaj, MD, PhD35

1CHU, Caen, France
2APHM, Bobigny, France
3Hematologie, Centre Hospitalier Universitaire, Université de Lille 2, Lille, France
4Service d’Hématologie et Thérapie Cellulaire, UMR CNRS 7292, CHU de Tours, Tours, France
5Hematology, CHU, Angers, France
6CHU Curie, paris, France
7APHP Necker, Paris, France
8APHP Necker, PARIS CEDEX 15, France
9Institut Paoli Calmettes, Marseille, France
10Hematology, Hopital Avicenne, Bobigny, France
11CHU, Strasbourg, France
12Hospital, Saint Quentin, France
13CHU, Valenciennes, France
14Stanford University, Stanford, CA
15Hematology Department, Centre hospitalier Sud Francilien, Corbeil, France
16Hospital, Meaux, France
17Hôpital de Boulogne-sur-Mer, Boulogne-sur-Mer, France
18Haematology Department, Caen University Hospital, Caen, France
19CHU, CAEN CEDEX 5, France
20CHU DE CAEN, Caen, France
21CHU, CAEN, France
22Department of Hematology, Hospices Civils de Lyon, Pierre-Benite, France
23Hematology, Centre Hospitalier Universitaire, Amiens, France
24Chu Amiens, Salouel, France
25Oncology and Hematology Department, CH, La Roche-sur-Yon, France
26Hospital, Lyon, TX, France
27Hospital, Lyon, France
28Centre Hospitalier Regional Et Universitaire De Tours, Montpellier, France
29Department of Hematology, Centre National de Référence Maladies Rares: Amylose AL et Autres Maladies à Dépôts, CHU Limoges, Limoges, France
30CHU Clermont Ferrand, Clermont Ferrand Cedex 1, France
31CHU, Dijon, France
32CHU, Vandoeuvre Les Nancy, France
33Saint-Etienne University Hospital, Saint-Etienne, France
34Service d’Hématologie Clinique, Centre Henri Becquerel, Rouen Cedex, France
35Hematology Department, CHU Caen, Caen, France

Peripheral T-cell lymphoma (PTCL) is an aggressive disease with poor outcome. First line therapies are usually unsatisfactory with frequent need for second-line therapies. Median progression free survival (PFS) and overall survival (OS) for relapse PTCL patients are very short with few available therapeutic options. Bendamustine has been shown to be effective in this setting.

In order to assess the efficacy of bendamustine outside clinical trials, we conducted a national retrospective study of patients with the diagnosis of PTCL and who were treated with bendamustine. Between 2011 and 2013, about 200 patients with the diagnosis of PTCL have been treated in 27 centers with bendamustine. We present the results of 142 patients with complete clinical and biological data.

The population median age was 64y (range 28-89) with male/female sex ratio of 1,4 (83/59). Histologies were: angio-immunoblastic (AILT=63), PTCL-NOS (n=44), anaplasic-large (ALCL=13), NK/TCL (n=3), mycosis fungoides (MF=7), subcutaneous panniculitis-like-TCL (n=2), hepato-splenic-TCL (n=1) and others (n=9). The majority of patients (96%, n=130) had stage-disseminated disease and 72% (n=102) of them had extranodal localisations.

The median number of chemotherapy lines prior to bendamustine was 2 (range 0-8). Seven patients (5%) had received allogeneic stem cells transplantation (SCT) and 16 autologous SCT (11%) prior to bendamustine.  The median duration of response (DoR) after the last prior to bendamustine chemotherapy was 4.3 months (range 1-70) and 50% of patients had refractory disease at bendamustine treatment.

Seventy-four patients (52%) received less than 3 cycles, mostly because of disease progression. Overall, they received a median of 2 cycles (range 1-8) with a median dose of 90mg/m2 (range 50-150).

The best overall response rate (ORR) was 32% (45/141) with complete response of 24% (CR=34). The median DoR was 3.3 months (1-39). For AITL patients, ORR was 52% (33/63) with CR of 41%, whereas it was 18% (8/44) with 11% of CR, in patients with PTCL-nos, respectively (p=0.01). Nine patients (6%) received allogeneic SCT in CR. Median PFS was 3 months (range 0.2-46.3) and median OS was 4.4 months (range 0.2-55.4).  On multivariate analysis, chemotherapy refractory (p=0.001) patients’ and extranodal disease localization (p=0.028) before bendamustine influenced adversely the ORR.

With a median follow up 4.4 months, 72% of patients (102/142) died. The most frequent cause of death were: disease progression (92%) or toxicities (6%). Grade 3-4 thrombocytopenia, neutropenia and infections were reported in 22%, 17% and 23% of cases, respectively.

Bendamustine as single agent must be considered as a therapeutic option for relapsed or refractory PTCL, particularly in patients with AITL. The safety profile was good. Combination of bendamustine with other drugs should be evaluated prospectively.

Disclosures: Off Label Use: Bendamustine, single molecule, alkylant agent with antimetabolite properties. Morschhauser: Genentech Inc./Roche: Other: Advisory boards . Cartron: Sanofi: Honoraria ; GSK: Honoraria ; Celgene: Honoraria ; Gilead: Honoraria ; Roche: Consultancy , Honoraria .

*signifies non-member of ASH