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Immunochemotherapy With Rituximab-Bendamustine-Cytarabine for Patients With Mantle Cell Lymphoma Not Eligible for Intensive Regimens or Autologous Transplantation.

Phase 2
18 Years
Not Enrolling
Lymphoma, Mantle-Cell

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Trial Information

Immunochemotherapy With Rituximab-Bendamustine-Cytarabine for Patients With Mantle Cell Lymphoma Not Eligible for Intensive Regimens or Autologous Transplantation.

Since Bendamustine has recently shown promising safety and efficacy in combination with
monoclonal antibodies in the treatment of patients with MCL, the goal of this study is to
investigate the possible therapeutic benefit of combining Ara-C with Bendamustine and
Rituximab (R-BAC). All three agents exhibit individual and unique mechanisms of action in
MCL, and a synergistic or additive effect might be expected when these agents are used in
combination, as suggested by the pre-clinical studies.

Inclusion Criteria:

- Previously untreated patients with MCL aged 65 years or more, or <65 years if not
eligible for intensive treatments including/not including autologous transplantation.

- MCL patients of any age who relapse/progress or are resistant after one line of

- CD20+ .

- Karnofsky score of at least 70%

- Adequate renal function (Creatinine clearance >40 mL/min), with preserved diuresis.

- Adequate liver function: alanine aminotransferase (ALT)/aspartate aminotransferase
(AST) <2.5 x upper limit of normal (ULN) value, total bilirubin <2 mg/dL, unless
directly attributable to the patient's tumor.

- Negative serum pregnancy test 1 week prior to treatment both for pre-menopausal women
and for women who are <2 years after onset of menopause.

- Hepatitis B core antibody (HBcAb) positive patients may be enrolled if correct
antiviral prophylaxis is administered at least 2 weeks before initiating protocol

- Written informed consent.

Exclusion Criteria:

- Prior treatment with Bendamustine.

- Refractoriness to Rituximab, defined as progressive disease during a previous cycle
including this drug, or relapse within 6 months to any previous cycle including

- Previous Rituximab infusion-related severe reactions.

- Human immunodeficiency virus (HIV) positive.

- Medical conditions or organ injuries that could interfere with administration of

- Active bacterial, viral, or fungal infection requiring systemic therapy.

- Seizure disorders requiring anticonvulsant therapy.

- Severe chronic obstructive pulmonary disease with hypoxaemia.

- History of severe cardiac disease: New York Heart Association (NYHA) functional class
III-IV, myocardial infarction within 6 months, ventricular tachyarrhythmias,
dilatative cardiomyopathy, or unstable angina.

- Uncontrolled diabetes mellitus.

- Active secondary malignancy.

- Known hypersensitivity or anaphylactic reactions to murine antibodies and proteins
(for patients treated with Rituximab), to Bendamustine or mannitol.

- Fertile men and women of childbearing potential unless surgically sterile or using
adequate measures of contraception.

- Major surgery within 4 weeks of study Day 1.

- HBsAg+ and HCV+ patients

- Any co-existing medical or psychological condition that would preclude participation
in the study or compromise the patient's ability to give informed consent, or that
may affect the interpretation of the results, or render the patient at high risk from
treatment complications.

Type of Study:


Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

The safety and tolerability of R-BAC treatment will be tested to determine the dose limiting toxicity (DLT) and maximum tolerated dose (MTD) of Ara-C when combined with Bendamustine and Rituximab.

Outcome Time Frame:

June 2011

Safety Issue:


Principal Investigator

Carlo Visco, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Department of Hematology, San Bortolo Hospital, Vicenza


Italy: Ethics Committee

Study ID:




Start Date:

June 2009

Completion Date:

June 2012

Related Keywords:

  • Lymphoma, Mantle-cell
  • Lymphoma, Mantle-Cell
  • Bendamustine
  • Cytarabine
  • Rituximab
  • Treatment
  • Combination chemotherapy
  • Lymphoma
  • Lymphoma, Mantle-Cell