LLC chimiotherapie Levact (molécule Bendamustine ) (TREANDA) = AGENT ALKYLANT

Bendamustine (TREANDA) = AGENT ALKYLANT As a chemotherapy with alkylating properties, TREANDA can kill CLL cells

dans une étude les effets secondaire de la Bendamustine sont plus importants que ceux du chlorambucil.: (2009)

Toxicity was worse with Bendamustine. Grade 3 or 4 adverse events occurred in 40% for Bendamustine and 19% for Chlorambucil.

un grade 3 est sévère
un grade 4 a des conséquence sur les conditions de vie (Life-threatening or disabling AE)

ci dessous avis du Dr Terry Hamblin

"So in summary, despite my misgivings about how Bendamustine has been brought to the market, it does seem to have an advantage over standard alkylating agents in producing rather more CRs and a higher response rate. Dosing is crucial, however, The haematological toxicity is much higher than is seen with chlorambucil. Some years ago there was a trial of chlorambucil in Yugoslavia, which pushed the drug to toxic levels and produced results that were superior to those of fludarabine. This may be what we are seing with Bendamustine. In previously treated patients the maximum tolerated dose is 140 mg/sq m/month and in untreated patients it is 200 mg/ sq m/month. In combinations with other chemothereutic drugs this should be reduced.

It does have some activity in del 17p disease but there are better options and it should certainly not be first choice.

Bendamustine has to be given iv which is a disadvantage over chlorambucil, cyclphosphamide and fludarabine."