'Use it again!': retherapy with bendamustine in indolent B-cell lymphoproliferative disorders

A pattern of relapse followed by further therapy is prevalent in patients with indolent lymphoid malignancies indicating the need for additional effective salvage therapies. Previous therapy, response and duration of response to that therapy are among the most important factors in determining the next therapy. Bendamustine, a bifunctional alkylating agent, has been tested alone or in combination in patients with chronic lymphocytic leukemia and indolent non-Hodgkin's lymphomas. In this article, the authors reported data, collected retrospectively, regarding repeatedly treating patients affected by indolent lymphoid malignancies with bendamustine-including regimens at the moment of relapse. Their experience showed that this drug is effective and manageable even when reused in both settings: chronic lymphocytic leukemia and non-Hodgkin's lymphomas combined with rituximab and/or mitoxantrone. The slow evolution in the treatment of patients with lymphoid malignancies has recently given way to a major revolution. Over the past decade, the availability of novel and active targeted agents, particularly monoclonal antibodies, has engendered major progress in the treatment of both aggressive and indolent lymphoid malignancies. Despite the fact that new therapeutic strategies are relying less on nonspecific cytotoxic drugs and more on targeted agents, a pattern of relapse followed by further therapy is prevalent in patients with indolent lymphoid malignancies, indicating the need for additional effective salvage therapies.