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Bendamustine plus rituximab for the treatment of Waldenström Macroglobulinaemia: patient outcomes and impact of bendamustine dosing

Arulogun, Suzanne O.; Brian, Duncan; Goradia, Harshita; Cooney, Aaron; Menne, Tobias; Koo, RayMun; O’Neill, Aideen T.; Vos, Josephine M.I.; Pratt, Guy; Turner, Deborah; Marshall, Kirsty; Manos, Kate; Anderson, Claire; Gavriatopoulou, Maria; Kyriakou, Charalampia; Kersten, Marie J.; Minnema, Monique C.; Koutoumanou, Eirini; El-Sharkawi, Dima; Linton, Kim; Talaulikar, Dipti; McCarthy, Helen; Bishton, Mark; Follows, George; Wechalekar, Ashutosh; D’Sa, Shirley P.


Suzanne O. Arulogun

Duncan Brian

Harshita Goradia

Aaron Cooney

Tobias Menne

RayMun Koo

Aideen T. O’Neill

Josephine M.I. Vos

Guy Pratt

Deborah Turner

Kirsty Marshall

Kate Manos

Maria Gavriatopoulou

Charalampia Kyriakou

Marie J. Kersten

Monique C. Minnema

Eirini Koutoumanou

Dima El-Sharkawi

Kim Linton

Dipti Talaulikar

Helen McCarthy

Mark Bishton

George Follows

Ashutosh Wechalekar

Shirley P. D’Sa


Bendamustine and rituximab (BR) therapy is commonly used in the treatment of Waldenström Macroglobulinaemia (WM). The impact dose of Bendamustine dose on response and survival outcomes is not well established, and the impact of its use in different treatment settings is not clear. We aimed to report response rates and survival outcomes following BR, and clarify the impact of depth of response and bendamustine dose on survival.

A total of 250 WM patients treated with BR in the frontline or relapsed settings were included in this multicentre, retrospective cohort analysis.

Rates of partial response (PR) or better differed significantly between the frontline and relapsed cohorts (91.4% vs 73.9%, respectively; p<0.001). Depth of response impacted survival outcomes: two-year predicted PFS rates after achieving CR/VGPR vs PR were 96% vs 82%, respectively (p=0.002). Total bendamustine dose was predictive of PFS: in the frontline setting, PFS was superior in the group receiving ≥1000mg/m2 compared with those receiving 800-999mg/m2 (p=0.04). In the relapsed cohort, those who received doses of <600mg/m2 had poorer PFS outcomes compared with those who received ≥600mg/m2 (p=0.02).

Attaining CR/VGPR following BR results in superior survival, and total bendamustine dose significantly impacts response and survival outcomes, in both frontline and relapsed settings.


Arulogun, S. O., Brian, D., Goradia, H., Cooney, A., Menne, T., Koo, R., …D’Sa, S. P. (in press). Bendamustine plus rituximab for the treatment of Waldenström Macroglobulinaemia: patient outcomes and impact of bendamustine dosing. American Journal of Hematology,

Journal Article Type Article
Acceptance Date Feb 20, 2023
Deposit Date Feb 22, 2023
Journal American Journal of Hematology
Print ISSN 0361-8609
Electronic ISSN 1096-8652
Publisher Wiley
Peer Reviewed Peer Reviewed
Keywords Chemotherapy, immunotherapy, outcomes research, non-Hodgkin lymphoma, neoplasia-myeloma and other plasma cell dyscrasias
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Additional Information Accepted manuscript online: 03 March 2023. Manuscript accepted: 20 February 2023. Manuscript revised: 01 February 2023. Manuscript received: 07 November 2022.