Background and aim: Non-Hodgkin lymphoma (NHL) is the most prevalent hematological malignancy worldwide. Outcome of lymphoma has definitely improved over the last few decades. Nevertheless, notable group of patients may display a poor response to treatment with a true refractoriness or a transient response followed by early relapse which represent approximately one quarter of NHL cases undergoing induction therapy who remains a major cause of morbidity and mortality with only a small percentage will experience prolonged disease-free survival with salvage chemo immunotherapy. Bendamustine had been suggested in previous studies as a second line therapy for relapsed /refractory (RlR) NHL .This study aimed to evaluate the efficacy and safety of using the Bendamustine as single agent in RlR NHL patients. Patients and Methods: A prospective, single arm study that was carried out on twenty five patient diagnosed as RlR NHL who previously received at least one salvage line of chemotherapy. Patient received bendamustine at dose of 120 mg/ m2 in day 1 and 2 every 3 weeks for 3 cycles intravenous with 250 ml saline over 60 minute then reassessed. Results: Study revealed that overall response rate was 60% with patients had complete remission (CR) was (20%), (40%) achieved partial remission (PR), (4%) had stationary disease (SD) and (36%) had progressive disease. Overall survival was 72 % at 12 months and 66 % at 24 months. Moreover, median for progression free survival (PFS) is 12 months with range of (2-24) month, PFS was 68% at 6 months, 63.8 % at 12 months and 63.8 % at 24 months. In our study three (12%) patients had no toxicity and 22 (88%) patients developed toxicity. The main toxic effects are haematological. Eighteen (72%) patients developed haematological toxicity and four (16%) developed non-haematological toxicity. According to haematological toxicity one of them (4%) had thrombocytopenia grade 1-2. Four (16%) of them had thrombocytopenia grade 3-4.Two (8%) patients had neutropenia grade 1-2 (one of them had febrile neutropenia). Seven (28%) patients had neutropenia grade 3-4 (three of them had febrile neutropenia. Two (8%) patients had anemia grade1-2. Two (8%) of them had anemia grade 3-4. According to patients who had non-haematological toxicity. One (4%) of them had fatigue grade 3-4. One (4%) of them had vomiting grade1-2 .Two(8%) patients had diarrhea grade 1-2 this showed that bendamustine is tolerated with low haematological and non-haematological toxicity profile. Conclusion: Bendamustine is suggested to be an effective regimen in treatment of RlR NHL with high response rate and low toxicity profile
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