Rituximab, bendamustine and cytarabine (R-BAC) in patients with relapsed-refractory aggressive B-cell lymphoma

Rituximab, bendamustine and cytarabine (R-BAC) in patients with relapsed-refractory aggressive B-cell lymphoma.

Management of diffuse large B-cell lymphoma (DLBCL) after failure of front-line immunochemotherapy is a treatment challenge, without a clear optimal salvage strategy, especially for patients not candidate to autologous stem cell transplantation (ASCT). 1 Few patients achieve long-term disease control and no standard therapy exists. The British Columbia Cancer Agency reported a median progression-free survival (PFS) and overall survival (OS) of 2.1 and 3.9 months, respectively, in 326 patients who were not candidate for ASCT. 2 Among most widely used salvage regimens, the combination of rituximab and bendamus- tine (BR) was associated with overall response (OR) ranging from 32 to 63%, and PFS of 3-8 months. 3,4 When combined with cytara- bine, bendamustine has demonstrated significant synergistic activity in preclinical studies on DLBCL. 5 Thus, we conducted a pilot trial to explore the efficacy and tolerability of R-BAC (rituximab, bendamus- tine, and cytarabine) in a cohort of patients with B cell relapsed/ refractory (R/R) aggressive lymphoma.