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The primary end-point was the response rate. Secondary end-points included PFS, and overall survival (OS), which were calculated according to the Kaplan and Meier method. Time to progression and OS were measured from the start of R-BAC treatment until disease progression or death, respectively. To assess IGHV gene mutational status, RNA was obtained from peripheral blood or bone marrow specimens. Sequences were aligned to IMGT and analyzed using IMGT/VQUEST software. Sequences differing http://www.selleckchem.com/products/Rapamycin.html or at the time of study entry. The R-BAC regimen [19] consisted of rituximab (375 mg/m2, Day 1 of first cycle, then 500 mg/m2 for subsequent cycles), bendamustine (70 mg/m2, Days 1�C2, given as a 1-hr infusion) and cytarabine (800 mg/m2, Day 1�C3, given as a 2-hr infusion starting 2 hr after bendamustine). Cycles were repeated on Day 29 if the patient had sufficient hematopoietic recovery, or otherwise postponed for at least two more weeks. A maximum of four cycles was planned. Therapy was stopped after two cycles if no partial or complete response was obtained. A cytarabine reduction to 500 mg/m2 was planned for patients older than 70 years, for those with inadequate cell count recovery on Day 29 and for Patient 10 who had relapsed after alloHCT. Primary prophylaxis with granulocyte http://www.selleckchem.com/products/jq1.html colony-stimulating factor was routinely used starting from Day 5 after chemotherapy completion, and lasting for 3�C6 days or until neutrophil count recovery. The use of erythropoietin was allowed. Rituximab premedication included antihistamines and paracetamol/acetaminophen. Allopurinol was used as prevention of tumor lysis syndrome for at least the first week of treatment. Corticosteroids were not routinely used to pre-medicate rituximab, but were used in case of infusion-related reactions. The use of systemic steroids or steroid-based collyrium was allowed during treatment with cytarabine, http://www.selleck.cn/products/AP24534.html but was restricted to the days of active treatment. Cytarabine was preceded by Dexamethasone 4 mg IV to avoid treatment related systemic side effects. Responses were graded according to NCI WG criteria [20]. After completion of therapy, patients were followed at 3-month intervals until documented relapse or death to assess duration of response. Response assessment after two and four cycles included physical examination, complete blood count, peripheral blood, and bone marrow examination inclusive of flow cytometry evaluation. Computed tomography or ultra sound was performed in all patients with evidence of tumor mass before treatment.