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After application of a 30-minute infusion of bendamustine once every 3 weeks, the maximum tolerated dose (MTD) was 280 mg/m2. Cardiac events of CTC grade 2 occurred, which were compatible with ischemic ECG changes that were regarded as dose limiting.
In a subsequent study with a 30-minute infusion of bendamustine at day 1 and 2 every 3 weeks, the MTD was found to be 180 mg/m2. The dose limiting toxicity was grade 4 thrombocytopenia. Cardiac toxicity was not dose-limiting with this schedule.
Counter measures: There is no specific antidote. Bone marrow transplantation and transfusions (platelets, concentrated erythrocytes) may be made or hematological growth factors may be given as effective countermeasures to control hematological side-effects.
Bendamustine hydrochloride and its metabolites are dialyzable to a small extent.
