From the Guidelines
The main side effects of bendamustine include fatigue, rash, headache, constipation, and cytopenias, which may be prolonged, especially in heavily treated patients. According to the study published in the Mayo Clinic Proceedings in 2017 1, bendamustine is a multifunctional alkylating agent that is often used to treat lymphoid malignant neoplasms and has single agent activity in multiple myeloma. The major adverse effects of bendamustine are listed as fatigue, rash, headache, constipation, and cytopenias.
Some of the key side effects of bendamustine are:
- Fatigue
- Rash
- Headache
- Constipation
- Cytopenias, which may be prolonged, especially in heavily treated patients
A more recent study published in the Journal of the National Comprehensive Cancer Network in 2023 1 evaluated the combination therapy with bendamustine, carfilzomib, and dexamethasone in patients with relapsed/refractory multiple myeloma. The most common adverse events of grade 3 or higher included lymphopenia, neutropenia, and thrombocytopenia. However, since the question is about the main side effects of bendamustine, the study from 2017 1 is more relevant as it specifically discusses the side effects of bendamustine.
It is essential to note that the severity of side effects may vary between individuals and may depend on dosage, treatment duration, and combination with other medications. Therefore, it is crucial to closely monitor patients receiving bendamustine and adjust the treatment plan accordingly to minimize the risk of adverse effects.
From the FDA Drug Label
The most common non-hematologic adverse reactions (≥30%) were nausea (75%), fatigue (57%), vomiting (40%), diarrhea (37%) and pyrexia (34%) The most common non-hematologic Grade 3 or 4 adverse reactions (≥5%) were fatigue (11%), febrile neutropenia (6%), and pneumonia, hypokalemia and dehydration, each reported in 5% of patients. Adverse reactions occurring less frequently but possibly related to bendamustine hydrochloride treatment were hemolysis, dysgeusia/taste disorder, atypical pneumonia, sepsis, herpes zoster, erythema, dermatitis, and skin necrosis. Non-hematologic adverse reactions are shown in Table 4 In the randomized CLL clinical study, non-hematologic adverse reactions (any grade) in the bendamustine hydrochloride group that occurred with a frequency greater than 15% were pyrexia (24%), nausea (20%), and vomiting (16%) Other adverse reactions seen frequently in one or more studies included asthenia, fatigue, malaise, and weakness; dry mouth; somnolence; cough; constipation; headache; mucosal inflammation and stomatitis.
The main side effects of Bendamustine (Treanda) are:
- Gastrointestinal symptoms: nausea, vomiting, diarrhea
- Fatigue and asthenia
- Pyrexia
- Hematologic abnormalities: anemia, neutropenia, thrombocytopenia
- Infections: pneumonia, febrile neutropenia, sepsis
- Skin reactions: rash, pruritus, erythema, dermatitis
- Other adverse reactions: hemolysis, dysgeusia/taste disorder, atypical pneumonia, herpes zoster, mucosal inflammation and stomatitis 2 2
From the Research
Side Effects of Bendamustine (Treanda)
The main side effects of Bendamustine (Treanda) include:
- Nausea 3
- Weight loss 3
- Fatigue 3, 4
- Infection 4
- Tachyarrhythmia 4
- Cytopenia, including neutropenia, anemia, and thrombocytopenia 5
- Aplastic anaemia, a rare but severe side effect 5
- Severe dermatologic reactions, including cutaneous drug reactions 6
- Hemolytic anemia, a rare but potentially life-threatening side effect 7
- Pancytopenia, characterized by a decrease in red blood cells, white blood cells, and platelets 5, 7
Haematological Side Effects
Haematological side effects of Bendamustine (Treanda) include:
- Neutropenia, a decrease in neutrophil count 5
- Anemia, a decrease in red blood cell count 5, 7
- Thrombocytopenia, a decrease in platelet count 5
- Aplastic anaemia, a rare but severe side effect characterized by a failure of the bone marrow to produce blood cells 5
Non-Haematological Side Effects
Non-haematological side effects of Bendamustine (Treanda) include: