Khan Zurrya Fasih, Saeed Nabiha, Jehanzeb Hamzah, Jahangir Faryal, Shaikh Usman, Adil Salman, Khan Mehmood Alam, Daniyal Muhammad, Jamshed Mian Muinuddin, Ali Maria, Ali Natasha
Department of Oncology, Aga Khan Hospital, Karachi, Pakistan.
Department of Medicine, Aga Khan Hospital, Karachi, Pakistan.
J Cancer Allied Spec. 2024 Aug 16;10(2):677. doi: 10.37029/jcas.v10i2.677. eCollection 2024.
Indolent non-Hodgkin's lymphomas (NHLs) are a diverse category of malignancies characterized by a chronic relapsing-remitting disease course. In the modern era, patients usually receive a combination of bendamustine plus rituximab as the initial therapy, otherwise known as an R-Benda regimen. While clinical trials have demonstrated R-Benda to be superior to other regimens, our study aims to provide insight into real-world outcomes of R-Benda therapy.
We conducted a retrospective study for January 2015-July 2022 among patients receiving R-Benda for indolent NHLs at the Aga Khan University Hospital, Karachi, Pakistan. All patients underwent pre- and post-treatment assessment through positron emission tomography scan and computed tomography (CT) imaging. The response to treatment was assessed, and the overall survival (OS) and progression-free survival (PFS) were assessed using a Kaplan-Meier survival analysis.
We enrolled 118 patients, out of which the majority were elderly males (64%). The 2-year follow-up rate was 76.3% ( = 90), and the median follow-up time was 29 months. The most common histopathology encountered was follicular lymphoma (52%) presenting with stage IV disease (56%). Approximately 73% experienced a complete metabolic response to the treatment. Of these, 31.4% subsequently experienced a relapse. In addition, 17.7% of patients underwent a partial response, while 7% had refractory disease. The mean OS was 140 months (95% CI: 120-160), while the lower quartile value was 50 months. On the other hand, the median PFS was 80 months (95% CI: 43-N/A).
Our study demonstrated that patients on R-Benda had good clinical outcomes, with the vast majority living beyond 50 months. Moreover, 76.1% had no disease progression for the first 2 years. It adds to the existing body of literature that demonstrates that in real-world experience, the outcomes of R-Benda treatment are better than those reported by earlier randomized-control trials.
惰性非霍奇金淋巴瘤（NHL）是一类多样的恶性肿瘤，其特征为慢性复发-缓解病程。在现代，患者通常接受苯达莫司汀联合利妥昔单抗作为初始治疗，即所谓的R-Benda方案。虽然临床试验已证明R-Benda方案优于其他方案，但我们的研究旨在深入了解R-Benda治疗的真实世界疗效。
我们对2015年1月至2022年7月期间在巴基斯坦卡拉奇阿迦汗大学医院接受R-Benda方案治疗惰性NHL的患者进行了一项回顾性研究。所有患者均通过正电子发射断层扫描和计算机断层扫描（CT）成像进行治疗前和治疗后评估。评估治疗反应，并使用Kaplan-Meier生存分析评估总生存期（OS）和无进展生存期（PFS）。
我们纳入了118例患者，其中大多数为老年男性（64%）。2年随访率为76.3%（n = 90），中位随访时间为29个月。最常见的组织病理学类型是滤泡性淋巴瘤（52%），表现为IV期疾病（56%）。约73%的患者对治疗有完全代谢反应。其中，31.4%随后复发。此外，17.7%的患者有部分反应（PR），而7%的患者有难治性疾病。平均OS为140个月（95%CI：120 - 160），下四分位数为50个月。另一方面，中位PFS为80个月（95%CI：43 - N/A）（未达到）。
我们的研究表明，接受R-Benda方案治疗的患者临床疗效良好，绝大多数患者生存超过50个月。此外，76.1%的患者在最初2年内无疾病进展。这为现有文献增添了内容，表明在真实世界经验中，R-Benda治疗的疗效优于早期随机对照试验报告的疗效。
