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First-line treatment with bendamustine and rituximab, in patients with intermediate-/high-risk splenic marginal zone lymphomas

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Abstract

Splenic marginal zone lymphomas (SMZLs) are rare indolent B cell neoplasms that affect the spleen, bone marrow, and blood. Although they have an indolent course in the majority of patients, who have a median survival of 8–10 years, ∼ 30% may experience a worse outcome. The prognostic criteria of progression are lymph node and extra-nodal involvement, high lymphocyte counts, anaemia, and thrombocytopenia. The treatment of SMZLs include a “wait and watch strategy”, splenectomy, and alkylating agents ± rituximab. We here describe data relating to 70 patients with intermediate-/high-risk SMZLs, who received rituximab/bendamustine as first-line treatment for a median of 60 days (range 1–75) after diagnosis. Sixty patients (86%) achieved a complete response (CR), and seven (10%) a partial response (PR). Three patients (4.3%) experienced disease progression (PD). The median duration of remission was 18 months. Side effects were generally mild. Our findings suggest that rituximab/bendamustine is a feasible treatment option in patients with intermediate-/high-risk SMZLs.

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References

  1. Zibellini S, Capello D, Forconi F, et al. Stereotyped patterns of B-cell receptor in splenic marginal zone lymphoma. Haematologica. 2010;95:1792–6. http://www.ncbi.nlm.nih.gov/pubmed/20511668.

  2. Boveri E, Arcaini L, Merli M, et al. Bone marrow histology in marginal zone B-cell lymphomas: correlation with clinical parameters and flow cytometry in 120 patients. Ann Oncol Off J Eur Soc Med Oncol. 2009;20:129–36. http://www.ncbi.nlm.nih.gov/pubmed/18718888.

  3. Spina V, Rossi D. Molecular pathogenesis of splenic and nodal marginal zone lymphoma. Best Pract Res Clin Haematol. 30:5–12. http://www.ncbi.nlm.nih.gov/pubmed/28288716.

  4. Castelli R, Wu MA, Arquati M, et al. High prevalence of splenic marginal zone lymphoma among patients with acquired C1 inhibtor deficiency. Br J Haematol. 2016;172:902–8. http://www.ncbi.nlm.nih.gov/pubmed/26728240.

  5. Arcaini L, Rossi D, Lucioni M, et al. The NOTCH pathway is recurrently mutated in diffuse large B-cell lymphoma associated with hepatitis C virus infection. Haematologica. 2015;100:246–52. http://www.ncbi.nlm.nih.gov/pubmed/25381127.

  6. Carrier P, Jaccard A, Jacques J, et al. HCV-associated B-cell non-Hodgkin lymphomas and new direct antiviral agents. Liver Int. 2015;35:2222–7. http://www.ncbi.nlm.nih.gov/pubmed/26104059.

  7. Dasanu CA, Bockorny B, Grabska J, et al. Prevalence and pattern of autoimmune conditions in patients with marginal zone lymphoma: a single institution experience. Conn Med. 2015;79:197–200. http://www.ncbi.nlm.nih.gov/pubmed/26259295.

  8. Cugno M, Castelli R, Cicardi M. Angioedema due to acquired C1-inhibitor deficiency: a bridging condition between autoimmunity and lymphoproliferation. Autoimmun Rev. 2008;8:156–9.

    Article  CAS  PubMed  Google Scholar 

  9. Goldaniga M, Ferrario A, Cortelazzo S, et al. A multicenter retrospective clinical study of CD5/CD10-negative chronic B cell leukemias. Am J Hematol. 2008;83:349–54. http://www.ncbi.nlm.nih.gov/pubmed/18186522.

  10. Franco V, Florena AM, Iannitto E. Splenic marginal zone lymphoma. Blood. 2003;101:2464–72. http://www.ncbi.nlm.nih.gov/pubmed/12446449.

  11. Parry-Jones N, Matutes E, Gruszka-Westwood AM, et al. Prognostic features of splenic lymphoma with villous lymphocytes: a report on 129 patients. Br. J. Haematol. 2003;120:759–64. http://www.ncbi.nlm.nih.gov/pubmed/12614206.

  12. Arcaini L, Lazzarino M, Colombo N, et al. Splenic marginal zone lymphoma: a prognostic model for clinical use. Blood. 2006;107:4643–9. http://www.ncbi.nlm.nih.gov/pubmed/16493005.

  13. Rummel M, Kaiser U, Balser C, et al. Bendamustine plus rituximab versus fludarabine plus rituximab for patients with relapsed indolent and mantle-cell lymphomas: a multicentre, randomised, open-label, non-inferiority phase 3 trial. Lancet Oncol. 2016;17:57–66. http://www.ncbi.nlm.nih.gov/pubmed/26655425.

  14. Castelli R, Gidaro A, Deliliers GL. Bendamustine and Rituximab as first line treatment, in intermediate, high risk splenic marginal zone lymphomas of elderly patients. Mediterr J Hematol Infect Dis. 2016;8:e2016030. http://www.ncbi.nlm.nih.gov/pubmed/27413523.

  15. Arcaini L, Bruno R. Hepatitis C virus infection and antiviral treatment in marginal zone lymphomas. Curr Clin Pharmacol. 2010;5:74–81. http://www.ncbi.nlm.nih.gov/pubmed/20156155.

  16. Camacho FI, Mollejo M, Mateo MS, et al. Progression to large B-cell lymphoma in splenic marginal zone lymphoma: a description of a series of 12 cases. Am J Surg Pathol. 2001;25:1268–76. http://www.ncbi.nlm.nih.gov/pubmed/11688461.

  17. Cervetti G, Ghio F, Cecconi N, et al. How to treat splenic marginal zone lymphoma (SMZL) in patients unfit for surgery or more aggressive therapies: experience in 30 cases. J Chemother. 2017;29:126–9. http://www.ncbi.nlm.nih.gov/pubmed/27454143.

  18. Kalpadakis C, Pangalis GA, Dimopoulou MN, et al. Rituximab monotherapy is highly effective in splenic marginal zone lymphoma. Hematol Oncol. 2007;25:127–31. http://www.ncbi.nlm.nih.gov/pubmed/17514771.

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Authors and Affiliations

  1. Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Luigi Sacco Hospital Milan, 20157, Milan, Italy

    Roberto Castelli & Luigi Bergamaschini

  2. Fondazione Matterelli, Milan, Italy

    Giorgio Lambertenghi Deliliers

Authors
  1. Roberto Castelli
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  2. Luigi Bergamaschini
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  3. Giorgio Lambertenghi Deliliers
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Correspondence to Roberto Castelli.

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All authors have no conflicts of interest, and no patients received any type of grants.

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Castelli, R., Bergamaschini, L. & Deliliers, G.L. First-line treatment with bendamustine and rituximab, in patients with intermediate-/high-risk splenic marginal zone lymphomas. Med Oncol 35, 15 (2018). https://doi.org/10.1007/s12032-017-1076-1

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