How Bendamustine works
Bendamustine is an active ingredient used in cancer therapy – more precisely, in chemotherapy. As a representative of the alkylating cytostatic drugs, the active ingredient combats tumor cells by irreversibly changing the molecular structure of their genetic material (DNA). The cells can then no longer divide and multiply. As a result, they die.
Uptake, degradation and excretion
The cytostatic drug is broken down in the liver. Already 40 minutes after infusion, half of the active substance has been converted into ineffective intermediates, which are subsequently excreted in the stool.
When is Bendamustine used?
Bendamustine is used for the treatment of malignant tumors. It is approved for:
- Chronic lymphocytic leukemia (CLL)
- Non-Hodgkin’s lymphoma (NHL)
- Multiple myeloma (approved in Germany and Austria, but not in Switzerland)
How Bendamustine is used
Bendamustine is given to the patient as an infusion over a period of 30 to 60 minutes, usually on two consecutive days and then repeatedly at intervals of several weeks. Dosage is based on body surface area.
A typical treatment regimen is i.v. administration of 100-150mg of bendamustine per m2 of body surface area on days one and two every four weeks.
What are the side effects of bendamustine?
Common side effects include a lack of white blood cells (leukopenia) and platelets (thrombocyte penia). In addition, insomnia, heart dysfunction, high blood pressure, and difficulty breathing may occur.
Rarely, patients react allergically to bendamustine. In very rare cases, this results in anaphylactic shock. In addition, the nervous system may be affected, which can manifest itself, for example, in taste disturbances, painful bodily sensations and numbness. Acute circulatory failure is also possible.
Very rare side effects include multi-organ failure, infertility, and decreased cardiac function and even heart failure.
Contraindications
Bendamustine must not be given in the following cases:
- hypersensitivity to the active substance or to any of the other components of the drug
- severe liver dysfunction
- jaundice
- severe bone marrow disorder and severe change in blood count
- up to 30 days after major surgery
- infections
- Yellow fever vaccination
Interactions
Combination with tacrolimus or ciclosporin (both immunosuppressants) may lead to excessive suppression of the immune system.
Cytostatic drugs such as bendamustine may reduce antibody formation after vaccination has occurred. In the case of live vaccines, this can lead to dangerous, potentially life-threatening infections. Live vaccinations should therefore be administered in good time before or with sufficient interval after completion of Bendamustine treatment.
Age Limitation
Safety and efficacy of bendamustine in children and adolescents have not been established. Available data are insufficient to recommend a dose.
Pregnancy and lactation
Since it is not known whether bendamustine passes into breast milk, the active substance must not be used during breastfeeding. If use is necessary, breastfeeding must be stopped beforehand.
How to obtain medicines containing bendamustine
Bendamustine requires a prescription in Germany, Austria, and Switzerland and may only be administered by a doctor.
