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2017 ; 8
(6
): 197-205
Nephropedia Template TP
gab.com Text
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English Wikipedia
Bendamustine and its role in the treatment of unfit patients with chronic
lymphocytic leukaemia: a perspective review
#MMPMID28567239
Al-Sawaf O
; Cramer P
; Goede V
; Hallek M
; Pflug N
Ther Adv Hematol
2017[Jun]; 8
(6
): 197-205
PMID28567239
show ga
With a median age of 72 years at first diagnosis, chronic lymphocytic leukaemia
(CLL) is a disease of the elderly. At this age, many patients cannot bear an
intensive chemoimmunotherapy like fludarabine, cyclophosphamide and rituximab
(FCR), and therapeutic decisions are commonly complicated by a high burden of
accompanying comorbidities. Clinical trials, on the other hand, are mostly
designed to include a far healthier and younger trial population, with a median
age in most studies well below 70 years, leading to an insufficient reflection of
clinical reality. With the introduction of new targeted therapies, treatment of
CLL is currently undergoing a profound change. New compounds like ibrutinib or
idelalisib have enlarged the therapeutic options in treating CLL. However, so
far, these oral medications imply continuous intake by the patient, which will at
some point lead to the issue of adherence in most patients. In addition,
long-term experiences are largely missing. In this setting, one of the oldest
chemoactive substances remains a viable option for many CLL patients and their
treating physicians: bendamustine, a nitrogen-mustard derivative, has proven to
be a safe and efficient agent for treatment of CLL in the first- and second-line
setting. In particular, there is some evidence that the substance is relatively
well tolerated in elderly and unfit patients. In this review, we summarize the
current data on bendamustine in the treatment of elderly and unfit patients with
CLL and aim to provide a concise analysis and outlook on the current and future
role of this substance in the era of new targeted agents.