The concept fo cmbining bendmustine, mitozantrone and Rituxan is based on German reports of high activity of this regimen in follicular and mantle cell lymphomas. However, these results require confirmation and there are no guidelines that recommend this combination. A 2009 review condluded: “Overall, bendamustine has demonstrated promising results as therapy for non-Hodgkin’s lymphomas and should be included in the armamentarium of agents used to treat relapsed indolent non-Hodgkin’s lymphomas and may prove valuable as initial therapy for these diseases. Further studies are being conducted to demonstrate the efficacy of this drug in combination with other agents.”
In addition, the combination is in a study: Bendamustine, Mitoxantrone, and Rituximab (BMR) for Patients With Untreated High Risk Follicular Lymphoma, NCT00901927
Weide R, Hess G, Köppler H, Heymanns J, Thomalla J, Aldaoud A, Losem C, Schmitz S, Haak U, Huber C, Unterhalt M, Hiddemann W, Dreyling M; German Low Grade Lymphoma Study Group.
High anti-lymphoma activity of bendamustine/mitoxantrone/rituximab in rituximab pretreated relapsed or refractory indolent lymphomas and mantle cell lymphomas. A multicenter phase II study of the German Low Grade Lymphoma Study Group (GLSG). Leuk Lymphoma. 2007 Jul;48(7):1299-306.
V. Gandhi and J. A. Burger
Bendamustine in B-Cell Malignancies: The New 46-Year-Old Kid on the Block
Clin. Cancer Res., December 15, 2009; 15(24): 7456 – 7461.