Bendamustine for the treatment of relapsed or refractory peripheral T cell lymphomas: A French retrospective multicenter study.

Emilie Reboursiere (1) , Fabien Le Bras (2) , Charles Herbaux (3, 4) , Emmanuel Gyan (5, 6) , Aline Clavert (7) , Franck Morschhauser (8) , Sandra Malak (9) , David Sibon (10, 11) , Florence Broussais (12) , Thorsten Braun (13) , Luc-Matthieu Fornecker (14) , Reda Garidi (15) , Sabine Tricot (16) , Roch Houot (17, 18) , Bertrand Joly (19) , Wajed Abarah (20) , Bachra Choufi (21) , Anne-Dominique Pham (22, 23, 24) , Anne-Claire Gac (25) , Christophe Fruchart (1) , Emilie Marin (1) , Violaine Safar (26) , Anne Parcelier (27) , Hervé Maisonneuve (28) , Emmanuel Bachy (29) , Guillaume Cartron (30) , Arnaud Jaccard (31, 32) , Olivier Tournilhac (33, 34) , Cédric Rossi (35) , Luciane Schirmer (36) , Jean-Alain Martignoles (37) , Philippe Gaulard (38) , Hervé Tilly (39) , Gandhi Damaj (40, 41)

1 CHU Caen
2 CHU Henri Mondor [Créteil]
3 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
4 JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837
5 Service d'hématologie
6 CIC - Tours
7 Unité d'Investigation Clinique - Service d'Hématologie Clinique [Nantes]
8 Service d'hématologie
9 Institut Curie [Paris]
10 IMAGINE - U1163 - Imagine - Institut des maladies génétiques
11 ERL 8254 - Equipe Inserm U1163 - Laboratory of molecular mechanisms of hematologic disorders and therapeutic implications
12 Département d'Hematologie
13 Hôpital Avicenne [AP-HP]
14 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
15 Hôpital Saint-Quentin
16 Centre hospitalier [Valenciennes, Nord]
17 MiCa - Microenvironnement et cancer
18 Service d'hématologie clinique
19 Hôpital Sud-Fancilien
20 Centre Hospitalier de Meaux
21 EA 2686 - Laboratoire d'Immunologie
22 UBRC - Unité de Biostatistique et de Recherche Clinique
23 HEGP - Hôpital Européen Georges Pompidou [APHP]
24 CRC (UMR_S 872) - Centre de Recherche des Cordeliers
25 IDELE - Institut de l'élevage
26 Service d'hématologie clinique
27 CHU Amiens-Picardie
28 Service de Médecine Onco-hématologie [La Roche sur Yon]
29 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
30 Hôpital Gui de Chauliac [CHU Montpellier]
31 Service d'Hématologie clinique et thérapie cellulaire [CHU Limoges]
32 CRIBL - Contrôle de la Réponse Immune B et des Lymphoproliférations
33 Service d'Hématologie Clinique Adulte et de Thérapie Cellulaire
34 EA7283, CIC501
35 Service d'Hématologie Clinique (CHU de Dijon)
36 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
37 Institut de Cancérologie Lucien Neuwirth
38 IMRB - Institut Mondor de Recherche Biomédicale
39 GPL - Groupe d'étude des proliférations lymphoïdes
40 CEREMAST - Centre de référence des mastocytoses
41 Service d'Hématologie

Peripheral T-cell lymphoma (PTCL) is a group of diseases with poor outcome and few therapeutic options. We aimed to assess the efficacy of bendamustine in real life cohort of patients.Between November 2009 and March 2015, 138 PTCL patients were treated with bendamustine in 27 centers. Population median age was 64 (28-89) years with male/female ratio of 1.4. There were mainly angio-immunoblastic (AITL = 71), PTCL-not otherwise specified (PTCL-NOS = 40) and anaplastic large cell lymphoma (ALCL = 8). The majority of patients (96%) had disseminated disease and extranodal localizations (77%). Median number of chemotherapy lines prior to bendamustine was 2 (1-8). Median duration of response (DoR) after the last chemotherapy prior to bendamustine was 4.3 months (1-70) and 50% of patients had refractory disease.Median number of administered bendamustine cycles was 2 (1-8) and 72 patients (52%) received less than 3 mostly because of disease progression. Median dose was 90 (50-150) mg/m(2). Overall response rate (ORR) was 32.6% with complete response (CR) rate of 24.6% and median DoR was 3.3 months (1-39). AITL patients were more sensitive than PTCL-NOS patients (ORR: 45.1 versus 20%, p = 0.01). Median PFS and OS were 3.1 (0.2-46.3) and 4.4 (0.2-55.4) months. On multivariate analysis, refractory disease (p = 0.001) and extranodal localization (p = 0.028) adversely influenced ORR. Grade 3-4 thrombocytopenia, neutropenia and infections were reported in 22, 17 and 23% of cases respectively.Bendamustine as single agent could be considered as a therapeutic option for relapsed or refractory PTCL, particularly in chemosensitive or AITL patients. Combinations of bendamustine with other drugs warrant further evaluation.

Mots clés: bendamustine; efficacy; peripheral T cell lymphoma; safety

Domaines: Cancer

Emilie Reboursiere, Fabien Le Bras, Charles Herbaux, Emmanuel Gyan, Aline Clavert, et al.. Bendamustine for the treatment of relapsed or refractory peripheral T cell lymphomas: A French retrospective multicenter study.. Oncotarget, 2016, 7 (51), pp.85573-85583. ⟨10.18632/oncotarget.10764⟩. ⟨hal-01475957⟩