Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Drug

Bendamustine

An injectable chemotherapy drug for indolent lymphomas, mantle cell lymphoma and CLL

Updated: 27 October 20261 min read3 references
Generic name
Bendamustine
Brand names
Bendeka, Treanda, Levact
Drug class
Alkylating agent
Route
Intravenous infusion
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Key points

  • Bendamustine is given into a vein on two days in a row and repeated every 3 or 4 weeks [1].
  • With rituximab (BR), it controlled the disease longer than R-CHOP and caused fewer side effects [2].
  • It weakens the immune system for a long time; infection prevention is needed [1].

What is this drug and how does it work?

For patients

Bendamustine damages the DNA of cancer cells so they cannot divide [1]. It is usually given with rituximab.

For physiciansSpecialist notes
For physicians

An alkylating agent with a benzimidazole ring (a structure resembling a purine analogue) [1].

Which cancers is it used for?

For patients
What is this drug for?
  • Indolent B-cell lymphomas (follicular, marginal zone) and mantle cell lymphoma, with rituximab [1, 2]
  • Chronic lymphocytic leukaemia (now largely replaced by targeted drugs) [1, 3]
For physiciansApproved uses and evidence
For physicians
Approved uses and evidence
DiseaseUseKey evidence
Indolent and mantle cell lymphoma, first lineWith rituximab (BR)StiL NHL1: median progression-free survival 69.5 vs 31.2 months with R-CHOP [2]
CLL[1]Higher response and progression-free survival than chlorambucil [3]; targeted drugs are now preferred

How it is taken and dosing

Show detailsHide

A short infusion into a vein on two days in a row, every 28 days (in CLL and with rituximab) or every 21 days [1]. An anti-sickness medicine is given before the infusion.

For physiciansStandard dosing (FDA label), 1 regimen
For physicians

Standard dosing (FDA label)

Bendamustine

By diseaseCycle length: By regimen

By disease

DrugDoseRouteSchedule
CLL
Bendamustine100 mg/m²IV over 10 minutes (Bendeka)Days 1 and 2 every 28 days, up to 6 cycles
Rituximab-refractory lymphoma
Bendamustine120 mg/m²IVDays 1 and 2 every 21 days, up to 8 cycles
With rituximab (BR)
Bendamustine90 mg/m²IVDays 1 and 2 every 28 days
Cycle length
By regimen
Duration
Up to 6 cycles (BR)

Single-agent doses as per the label [1]; BR as in StiL NHL1 [2] (the BR regimen).

Evidence: StiL NHL1 (2013)

Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.

Side effects

For patients

The most common side effects: low blood cells and platelets, nausea and vomiting, fever, tiredness and skin rash [1].

For physiciansSpecialist notes
For physicians

Common adverse reactions (15% or more): anaemia, thrombocytopenia, neutropenia, lymphopenia, leucopenia, hyperbilirubinaemia, pyrexia, nausea and vomiting [1].

Serious side effects

For patients

Serious side effects: serious infections (even months after treatment), an allergic reaction during the infusion, severe skin rashes, tumour lysis, liver damage and skin damage if the drug leaks out of the vein [1].

For physiciansSpecialist notes
For physicians
  • Myelosuppression and prolonged lymphopenia; opportunistic infections (Pneumocystis, CMV, herpes) [1].
  • Infusion reactions; severe skin reactions (especially with allopurinol) [1].
  • Tumour lysis, hepatotoxicity, second malignancies, extravasation [1].

When should I call my doctor?

  • Fever or chills
  • A widespread rash or blisters
  • Burning or swelling at the infusion site
  • Yellowing of the skin or eyes

Interactions, pregnancy and precautions

  • Other medicines: allopurinol increases the risk of a severe skin reaction [1].
  • Pregnancy: this drug may harm an unborn baby; use effective contraception during treatment and tell your doctor straight away if you become pregnant. Do not breastfeed during treatment [1].
For patients

Frequently asked questions

Why are preventive antibiotics given after bendamustine?

Bendamustine keeps the lymphocytes low for a long time and raises the risk of particular infections [1].

Related cancer types

LeukaemiaLymphoma

Treatment regimens (physicians)

BR regimen (bendamustine and rituximab)

Related drugs

Arsenic trioxide (Trisenox)Azacitidine (Vidaza)Bortezomib (Velcade)Cyclophosphamide (Endoxan)Dasatinib (Sprycel)Doxorubicin (Adriamycin)EtoposideFilgrastim (Neupogen)

References

3 references
Show all references, 1 with a study cardClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    BENDEKA (BENDAMUSTINE HYDROCHLORIDE) — Prescribing InformationTeva Pharmaceuticals Usa, Inc · FDA label · 2026
    Source Back to text: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
  2. 2
    Bendamustine plus rituximab versus CHOP plus rituximab as first-line treatment for patients with indolent and mantle-cell lymphomas: an open-label, multicentre, randomised, phase 3 non-inferiority trialRummel MJ, Niederle N, Maschmeyer G, et al · Lancet · 2013;381:1203-10
    Study cardDOIPubMed Back to text: 1 2 3 4
  3. 3
    Phase III randomized study of bendamustine compared with chlorambucil in previously untreated patients with chronic lymphocytic leukemiaKnauf WU, Lissichkov T, Aldaoud A, et al · J Clin Oncol · 2009;27:4378-84
    DOIPubMed Back to text: 1 2

This page is based on reputable scientific sources and was last updated on 27 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/drugs/bendamustine/

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