Blood Res 2018; 53(3): 223-226  https://doi.org/10.5045/br.2018.53.3.223
Bendamustine, etoposide, and dexamethasone to mobilize peripheral blood hematopoietic stem cells for autologous transplantation in non-Hodgkin lymphoma
Adam M. Greenbaum1, Damian J. Green1, Leona A. Holmberg1, Ted Gooley1, Brian G. Till1, Lihua E. Budde2, Heather Rasmussen1, Oliver W. Press1, Ajay K. Gopal1
1Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 2Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
Correspondence to: Adam M. Greenbaum, M.D.Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N. D5-100, Seattle, WA 98109, USA E-mail: agreenba@fredhutch.org
Received: February 10, 2018; Revised: March 15, 2018; Accepted: May 10, 2018; Published online: September 30, 2018.
© The Korean Journal of Hematology. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
Bendamustine is a chemotherapeutic agent that has shown broad activity in patients with lymphoid malignancies. It contains both alkylating and nucleoside analog moieties, and thus, is not commonly used for stem cell mobilization due to concerns that it may adversely affect stem cell collection. Here we describe the lymphoma subset of a prospective, non-randomized phase II study of bendamustine, etoposide, and dexamethasone (BED) as a mobilization agent for lymphoid malignancies.
Methods
This subset analysis includes diffuse large B-cell lymphoma (N=3), follicular lymphoma (N=1), primary mediastinal B-cell lymphoma (N=1), and NK/T-cell lymphoma (N=1). Patients received bendamustine (120 mg/m2 IV d 1, 2), etoposide (200 mg/m2 IV d 1‒3), and dexamethasone (40 mg PO d 1‒4) followed by filgrastim (10 mcg/kg/d sc. through collection).
Results
We successfully collected stem cells from all patients, with a median of 7.9×106/kg of body weight (range, 4.4 to 17.3×106/kg) over a median of 1.5 days (range, 1 to 3) of apheresis. All patients who received transplants were engrafted using kinetics that were comparable to those of other mobilization regimens. Three non-hematologic significant adverse events were observed in one patient, and included bacterial sepsis (grade 3), tumor lysis syndrome (grade 3), and disease progression (grade 5).
Conclusion
For non-Hodgkin lymphoma, mobilization with bendamustine is safe and effective.
Keywords: Bendamustine, Stem cell mobilization, Non-Hodgkin lymphoma


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