Excellent response of rituximab and bendamustine in elderly patient with relapsed diffuse large B-cell lymphoma: a case report

Rituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is currently the most widely used first-line therapy for aggressive B-cell lymphomas. However, many patients, including those with organ dysfunction, may not tolerate the toxicities associated with this regimen. Recent data from the phase III study group indolent lymphomas (StiL) non-Hodgkin lymphoma (NHL)-1 trial suggested that bendamustine plus rituximab were superior in effectiveness and tolerability compared to R-CHOP in the treatment of indolent and mantle cell lymphomas. Preliminary study has indicated the effective use of bendamustine alone or in combination in the treatment of aggressive B-cell lymphomas as well. A 70-year-old male with heavily treated relapsed diffuse large B-cell lymphoma (DLBCL) showed complete remission (CR) after receiving 8 cycles of rituximab in combination with bendamustine as 3rd line treatment. Bendamustine has demonstrated considerable efficacy and well-tolerated therapy in relapsed DLBCL patients. Our case report demonstrated that treating patients with bendamustinebased regimen, even in the setting of organ impairment and elderly is safe and effective. Given the increasing evidence of its effectiveness, further investigation of bendamustine’s safety and tolerability aspects in special groups is recommended such as those with renal impairment.