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Updated: Nov 21, 2025

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Encephalopathy after Bendamustine Treatment: A Rare Side Effect?

Carolina Amado1, Gisela Ferreira2, Fernando Silva2

  • 1Internal Medicine Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.

European Journal of Case Reports in Internal Medicine
|January 18, 2021
PubMed
Summary

Bendamustine, a chemotherapy drug, can rarely cause delayed neurotoxicity like encephalopathy. Clinicians should consider this rare side effect when patients develop neurological symptoms after treatment.

Keywords:
Follicular lymphomabendamustineencephalopathyneurotoxicityrituximab

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Area of Science:

  • Oncology
  • Neuroscience
  • Pharmacology

Background:

  • Bendamustine is a chemotherapy agent used for lymphoid malignancies.
  • Common side effects include hematological and gastrointestinal issues.
  • Rarely, neurological toxicity has been reported.

Purpose of the Study:

  • To report a rare case of delayed encephalopathy potentially induced by bendamustine.
  • To highlight the diagnostic challenges and clinical awareness needed for this adverse effect.

Main Methods:

  • Case report of a 79-year-old male with follicular lymphoma.
  • Patient received R-CHOP followed by rituximab-bendamustine.
  • Encephalopathy developed two months post-treatment; other causes were excluded.

Main Results:

  • The patient developed progressive encephalopathy.
  • The condition was attributed to a delayed side effect of bendamustine, possibly exacerbated by rituximab.
  • Diagnosis of exclusion was necessary.

Conclusions:

  • Bendamustine neurotoxicity is a rare but significant adverse event.
  • Encephalopathy in patients treated with bendamustine requires careful evaluation to exclude other causes.
  • Discontinuation of bendamustine is the primary treatment for drug-induced encephalopathy.