Bendamustine-induced nephrogenic diabetes insipidus – A case report

Abstract

Introduction In patients with relapsed or refractory lymphoma, high-dose chemoimmunotherapy with subsequent autologous hematopoietic cell transplantation (HCT) is a standard of care. Bendamustine, an alkylating agent, is used in the BeEAM (bendamustine, etoposide, cytarabine, melphalan) protocol for conditioning therapy before autologous HCT in patients with relapsed or refractory lymphoma who are eligible for transplant. There is no consensus regarding an optimal salvage regimen and the approach varies according to toxicity. Case report We present a case of partial nephrogenic diabetes insipidus after receiving bendamustine, as part of the BeEAM protocol. Management and outcome: The patient was managed with parenteral fluid administration and intranasal desmopressin before the condition resolved on its own. Discussion We summarize published reports of bendamustine-induced diabetes insipidus.

Post-marketing risk analysis of bendamustine: a real-world approach based on the FAERS database

“…Notably, hypogammaglobulinemia presented the strongest signal (n = 44, χ 2 = 2,274.55), with reports of persistent hypogammaglobulinemia in indolent NHL patients treated with bendamustine and rituximab ( Sepulcri et al, 2021 ; Suzuki et al, 2022 ). Additionally, though nephrogenic diabetes insipidus had fewer reports (n = 4, χ 2 = 117.48), it showed significant signal strength, with cases presenting symptoms like polyuria and low urinary osmolality shortly after treatment ( Uwumugambi et al, 2016 ; Derman BA et al, 2017 ; Desjardins et al, 2022 ).…”