Optimal Use of Bendamustine in Chronic Lymphocytic Leukemia, Non-Hodgkin Lymphomas, and Multiple Myeloma: Treatment Recommendations From an International Consensus Panel

Bendamustine is a novel bifunctional alkylating agent with promising activity in lymphoid malignancies and several solid tumors. Unfortunately, the early development of this agent did not provide sufficient information on which to determine an optimal systematic dose and schedule. As a result, administration of the agent has been inconsistent among studies. The use of this drug has been increasing since it has been approved by the US Food and Drug Administration for chronic lymphocytic leukemia and rituximab-refractory indolent B-cell non-Hodgkin lymphoma, and is expected to increase further following anticipated European regulatory approval. Thus, a consensus meeting was convened to develop recommendations for standardizing the administration of the drug based on the available clinical data. Recommendations were developed including dose and schedule for the various clinical indications, as a single agent and in combination therapy, and to provide guidance for supportive measures. This report, representing the conclusions of that meeting, should provide guidance for the clinician until definitive dose-finding studies have been conducted.