Bendamustine, Methotrexate, Mitoxantrone, and Prednisolone (BMMP) for the Treatment of Relapsed or Refractory High-Grade Non-Hodgkin’s Lymphoma

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Abstract
Background: As part of the attempt to optimize the treatment of high-grade non-Hodgkin’s lymphoma (NHL) in advanced stages, a pilot study was designed to investigate the feasibility and efficacy of the BMMP protocol (bendamustine, methotrexate, mitoxantrone, prednisolone). Material and Methods: Between October 1994 and September 1996,23 elderly patients (median age 60.1 years; range: 20-80 years) with nonresponding or relapsed high-grade NHL were treated according to the BMMP protocol. Response and toxicity were determined on the basis of the WHO criteria. Results: Complete remission was achieved in 3 patients and partial remission in 8 patients, with an overall response rate of 47.8%. Disease remained stable in 1 patient and progressed in 11 patients. Side effects mostly oberserved in a total of 72 cycles administered were leukocytopenia (WHO grade III/IV) and thrombocytopenia (WHO grade III/IV), no patient died related to treatment-associated serious adverse events. Conclusions: The BMMP protocol is able to induce a remarkable rate of remissions in elderly patients with advanced NHL, who are not eligible for high-dose chemotherapy. Further randomized studies are needed and now unter way to compare the BMMP protocol with standard salvage chemotherpy regimens.

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