Science Highlights
Published on August 17, 2026
Bendamustine- and Fludarabine-Based Lymphodepletion in LBCL
by Transplantation and Cellular Therapy
Ahmed N, Ali A, Kim S, et al. Comparison of Fludarabine Versus Bendamustine as a Lymphodepleting Chemotherapy Prior to CAR-T for Large Cell Lymphoma. Transplantation and Cellular Therapy. 2026; (doi: 10.1016/j.jtct.2026.06.035).
New evidence upholds bendamustine as a viable alternative to fludarabine in lymphodepleting (LD) chemotherapy ahead of chimeric antigen receptor (CAR) T-cell treatment. In the context of relapsed/refractory large B-cell lymphoma (LBCL), pretreatment with LD chemotherapy helps CD19-directed CAR-T-cell therapy work more effectively. Little is known about how LD agents other than fludarabine perform in this setting, but a study of 5,256 patients with LBCL from the Center for International Blood and Marrow Transplant Research database sheds new light. The bulk of the sample, 92%, received fludarabine-based LD chemotherapy, while 9% received bendamustine-based LD chemotherapy. Researchers reported a lower overall response rate and higher relapse rate with bendamustine, which nonetheless matched fludarabine on both complete response and overall survival. Bendamustine was also associated with a superior toxicity profile characterized by lower rates of severe cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, and prolonged cytopenia.
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Transplantation and Cellular Therapy