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Bendamustine Effective for Lymphodepletion Before Tisagenlecleucel in Patients with R/R LBCL

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Bendamustine is safe and effective for lymphodepletion before tisagenlecleucel in patients with refractory or relapsed large B-cell lymphomas (LBCL), according to a study published in the Annals of Oncology.

The study compared the safety and efficacy of lymphodepletion using either fludarabine/cyclophosphamide (Flu/Cy; n=42) or bendamustine (n=90) before tisagenlecleucel in two cohorts of patients with refractory or relapsed LBCL treated at three academic institutions in the United States and Europe.

The results showed that the overall efficacy of tisagenlecleucel was similar between the two groups. Flu/Cy led to more profound lymphocytopenia after tisagenlecleucel infusion compared with bendamustine, although bendamustine produced better results in terms of the frequency and severity of adverse events. Patients treated with bendamustine had lower rates of cytokine release syndrome, neurotoxicity, and hematological toxicities.

Bendamustine-treated patients also had higher nadir neutrophil counts, hemoglobin levels, and platelet counts, as well as a shorter time to blood count recovery, and received fewer platelet and red cell transfusions. Fewer episodes of infection, neutropenic fever, and post-infusion hospitalization were observed in the bendamustine cohort compared with patients receiving Flu/Cy.

“Bendamustine for lymphodepletion before tisagenlecleucel has efficacy similar to Flu/Cy with reduced toxicities, … as well as reduced hospital utilization,” the authors wrote.

Ghilardi G, Chong EA, Svoboda J, et al. Bendamustine is safe and effective for lymphodepletion before tisagenlecleucel in patients with refractory or relapsed large B-cell lymphomas. Ann Oncol. 2022;S0923-7534(22)01722-7. doi:10.1016/j.annonc.2022.05.521

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