1
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Plante MÉ, Feng X, Boudreault JS. Single-center retrospective study assessing the efficacy and safety of BeEAM (bendamustine, etoposide, cytarabine, melphalan) as conditioning regimen for autologous hematopoietic stem cell transplantation. Leuk Lymphoma 2023; 64:1234-1242. [PMID: 37154396 DOI: 10.1080/10428194.2023.2203790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/01/2023] [Accepted: 04/09/2023] [Indexed: 05/10/2023]
Abstract
One of the most widely accepted conditioning regimens for hematopoietic stem cell transplantation (HSCT) is BEAM (carmustine, etoposide, cytarabine, melphalan). However, a recent increase in the cost of carmustine has limited its use bringing our institution to replace carmustine with bendamustine. This observational retrospective single-center study aims to report the efficacy and safety of the BeEAM regimen. 55 patients with diffuse large B-cell lymphoma (47%), Hodgkin lymphoma (25%), mantle cell lymphoma (25%), or follicular lymphoma (2%) were included. Progression-free survival (PFS) at 24 months was 75% and overall survival (OS) was 83%. Treatment-related mortality was 4%. The most common adverse effects were febrile neutropenia (98%), mucositis (72%) and colitis (60%). Our study demonstrated excellent efficacy of the BeEAM regimen. However, the toxicity profile of BeEAM significantly varies from one study to another, and guidelines suggesting optimal dose of bendamustine and supportive care are currently lacking.
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Affiliation(s)
- Marie-Élaine Plante
- Division of Hematology and Oncology, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Canada
| | - Xue Feng
- Division of Hematology and Oncology, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Canada
| | - Jean-Samuel Boudreault
- Division of Hematology and Oncology, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Canada
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2
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Huwyler F, Kunz R, Bacher U, Hoffmann M, Novak U, Daskalakis M, Banz Y, Pabst T. Evaluation of Bortezomib-BeEAM (2BeEAM) as Chemotherapy Regimen Prior to ASCT in Patients with Mantle Cell Lymphoma. Cancers (Basel) 2023; 15:cancers15072091. [PMID: 37046753 PMCID: PMC10093600 DOI: 10.3390/cancers15072091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/20/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
(1) Background: First-line therapy in fit MCL patients may comprise high-dose chemotherapy (HDCT) with autologous transplantation to consolidate remission before maintenance treatment. However, optimization of HDCT is an unmet clinical need given the substantial relapse rate of first-line treatment, while the use of bortezomib is a promising candidate to be added to standard HDCT. (2) Methods: We analyzed 11 consecutive patients with MCL who received bortezomib added to standard BeEAM (2BeEAM) HDCT at a single academic institution. We assessed safety, feasibility, toxicities, and survival rates. (3) Results: All patients had stage III or IV disease. We found that six patients (55%) developed new or worsening of preexisting peripheral neuropathy following administration of 2BeEAM HDCT. One patient relapsed within the first six months after HDCT, whereas three patients never reached complete remission. After a median follow-up of 22 months, the PFS was 64% and the OS 64% at the last follow-up assessment. At this time, 55% of patients were in CR. (4) Conclusions: The use of bortezomib added to standard BeEAM HDCT is associated with relevant toxicities, particularly with regards to additional neuropathy. Moreover, the anti-lymphoma efficacy of 2BeEAM HDCT appears to be modest; therefore, other therapeutic options should be evaluated for consolidation in this patient group.
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Affiliation(s)
- Fabrizio Huwyler
- Department of Medical Oncology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Rebekka Kunz
- Department of Medical Oncology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Ulrike Bacher
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Michèle Hoffmann
- Department of Medical Oncology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Urban Novak
- Department of Medical Oncology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Michael Daskalakis
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Yara Banz
- Institute of Pathology, Inselspital, University of Bern, 3008 Bern, Switzerland
| | - Thomas Pabst
- Department of Medical Oncology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
- Correspondence: ; Tel.: +41-31-632-8430; Fax: +41-31-632-3410
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3
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Heini AD, Beck P, Bacher U, Seipel K, Zander T, Daskalakis M, Pabst T. BeEAM Conditioning including High-Dose Bendamustine before Autologous Stem Cell Transplantation Is Safe and Effective in Patients with Waldenstrom's Macroglobulinemia. J Clin Med 2023; 12:jcm12062378. [PMID: 36983378 PMCID: PMC10057504 DOI: 10.3390/jcm12062378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
High-dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT) is an option to consolidate remission in Waldenstrom's macroglobulinemia (WM), particularly in selected younger patients with chemosensitive disease. BEAM, consisting of BCNU, etoposide, cytarabine, and melphalan, is often used as a conditioning regimen. However, problems with BCNU, including pneumotoxicity, tolerance, and availability, necessitate the search for alternatives. In this pilot study, we investigated high-dose chemotherapy with BeEAM, in which BCNU is replaced with high-dose bendamustine as an alternative conditioning regimen in six subsequent patients with WM. Bendamustine treatment was well tolerated without unexpected toxicities. The overall response rate was 6/6 patients (2 very good partial responses (VGPR) and 4 PR). After a median follow-up of 72 months, two (33%) patients relapsed. Median progression-free and overall survivals were not reached, and no severe late-onset toxicities were observed so far. In this pilot study, BeEAM conditioning before ASCT seems feasible, safe, and effective in patients with WM.
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Affiliation(s)
- Alexander D Heini
- Department of Medical Oncology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Philipp Beck
- Department of Medical Oncology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Ulrike Bacher
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
- Department for Biomedical Research, University of Bern, 3010 Bern, Switzerland
| | - Katja Seipel
- Department of Medical Oncology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Thilo Zander
- Division of Medical Oncology, Luzerner Kantonsspital, 6004 Lucerne, Switzerland
| | - Michael Daskalakis
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
- Department for Biomedical Research, University of Bern, 3010 Bern, Switzerland
| | - Thomas Pabst
- Department of Medical Oncology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
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4
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Rausch C, Bacher U, Rabaglio M, Vorburger C, Klingenberg A, Banz Y, Daskalakis M, Pabst T. Combining BeEAM with Brentuximab Vedotin for High-Dose Therapy in CD30 Positive Lymphomas before Autologous Transplantation—A Phase I Study. J Clin Med 2022; 11:jcm11185378. [PMID: 36143025 PMCID: PMC9503567 DOI: 10.3390/jcm11185378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022] Open
Abstract
The prognosis for patients with CD30+ lymphomas (Hodgkin lymphoma and various T-cell lymphomas) relapsing after autologous stem cell transplantation (ASCT) is critical. Brentuximab vedotin (BV), an ADC targeting CD30, is an obvious candidate for inclusion into high-dose chemotherapy (HDCT) regimens to improve outcomes. This single center phase I trial investigated 12 patients with CD30+ lymphoma (AITL: n = 5; relapsed HL: n = 7; median of two previous treatment lines) undergoing ASCT. In a 3 + 3 dose escalation design, 12 patients received a single BV dose at three dose levels (DL) (0.9/1.2/1.8 mg/kg b.w.) prior to standard BeEAM. All patients were treated as planned; no dose limiting toxicities (DLTs) occurred at DL 1 and 2. At DL 3, one DLT (paralytic ileus, fully recovering) occurred. Grade III febrile neutropenia occurred in one patient, and two others had septic complications, all fully recovering. Median hospitalization was 23 days. Hematologic recovery was normal. Six of twelve (50%) patients achieved CR. PFS and OS at 1 year were 67% (n = 8/12) and 83% (n = 10/12), respectively. The addition of brentuximab to standard BeEAM HDCT seems to be safe. We observed a CR rate of 75% post-ASCT in a highly pretreated population. The efficacy of this novel HDCT combination with BV at a 1.8 mg/kg dose level needs to be explored in larger studies.
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Affiliation(s)
- Christian Rausch
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
- Medical Department III—Hematology and Oncology, Campus Grosshadern, Ludwig Maximilian’s University Munich, 81377 Munich, Germany
| | - Ulrike Bacher
- Department of Hematology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - Manuela Rabaglio
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - Corinne Vorburger
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - Anke Klingenberg
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - Yara Banz
- Institute of Pathology, University of Bern, 3008 Bern, Switzerland
| | - Michael Daskalakis
- Department of Hematology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - Thomas Pabst
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
- Correspondence:
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5
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Wang YH, Hsieh CY, Hsiao LT, Lin TL, Liu YC, Yao M, Tan TD, Ko BS. Stem cell transplant for mantle cell lymphoma in Taiwan. Sci Rep 2022; 12:5662. [PMID: 35383213 PMCID: PMC8983774 DOI: 10.1038/s41598-022-09539-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/17/2022] [Indexed: 11/09/2022] Open
Abstract
Mantle cell lymphoma (MCL) is a B-cell lymphoma featuring an aggressive course and a progressive relapsing pattern. International guidelines recommend early consolidative autologous stem cell transplant (auto-SCT) for eligible patients while reserving allogeneic SCT (allo-SCT) as therapy for refractory cases. Since data describing the implementation of transplants in the Asian population with MCL are limited, we aimed to analyze post-SCT outcomes of 99 MCL patients from the Taiwan Bone Marrow Transplant Registry database. The median age was 56 years, and 11% of the patients had blastoid variant MCL. Ninety-four patients received auto-SCT, while 13 patients received allo-SCT, eight of which received allo-SCT after failing auto-SCT. Before auto-SCT, 52% of the patients were in their first complete remission (CR1). Overall, 37 patients (39%) relapsed after auto-SCT. The median post-auto-SCT progression-free survival and overall survival (OS) were 43.6 months and not reached, respectively. Blastoid variant MCL, transplant not received in CR1, and disease progression within 12 months post-auto-SCT independently predicted inferior OS in multivariable analysis. The median post-allo-SCT OS was 74 months. Two patients (15%) died of MCL recurrence post-allo-SCT. Three patients with refractory diseases were salvaged with ibrutinib or venetoclax to allo-SCT. Treatment strategies incorporating novel agents warrant further optimization.
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Affiliation(s)
- Yu-Hung Wang
- Stem Cell and Leukaemia Proteomics Laboratory, University of Manchester, Manchester, UK.,Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Yun Hsieh
- Division of Hematology and Oncology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Liang-Tsai Hsiao
- Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tung-Liang Lin
- Division of Hematology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yi-Chang Liu
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming Yao
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Tran-Der Tan
- Division of Hematology and Medical Oncology, Koo Foundation Sun Yat-Sen Cancer Center, No. 125, Lih-Der Road, Pei-Tou District, Taipei, 112, Taiwan.
| | - Bor-Sheng Ko
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. .,Department of Hematological Oncology, National Taiwan University Cancer Center, No. 57, Lane 155, Section 3 of Keelung Rd, Taipei, 100, Taiwan.
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6
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[Safety and the short-term efficacy of bendamustine in the conditioning regimen for autologous stem cell transplantation in patients with lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2022; 43:63-65. [PMID: 35231995 PMCID: PMC8980672 DOI: 10.3760/cma.j.issn.0253-2727.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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7
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Stokes J, Molina MS, Hoffman EA, Simpson RJ, Katsanis E. Immunomodulatory Effects of Bendamustine in Hematopoietic Cell Transplantation. Cancers (Basel) 2021; 13:1702. [PMID: 33916711 PMCID: PMC8038415 DOI: 10.3390/cancers13071702] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/25/2021] [Accepted: 04/01/2021] [Indexed: 12/22/2022] Open
Abstract
Bendamustine (BEN) is a unique alkylating agent with efficacy against a broad range of hematological malignancies, although investigations have only recently started to delve into its immunomodulatory effects. These immunomodulatory properties of BEN in the context of hematopoietic cell transplantation (HCT) are reviewed here. Pre- and post-transplant use of BEN in multiple murine models have consistently resulted in reduced GvHD and enhanced GvL, with significant changes to key immunological cell populations, including T-cells, myeloid derived suppressor cells (MDSCs), and dendritic cells (DCs). Further, in vitro studies find that BEN enhances the suppressive function of MDSCs, skews DCs toward cDC1s, enhances Flt3 expression on DCs, increases B-cell production of IL-10, inhibits STAT3 activation, and suppresses proliferation of T- and B-cells. Overall, BEN has a broad range of immunomodulatory effects that, as they are further elucidated, may be exploited to improve clinical outcomes. As such, clinical trials are currently underway investigating new potential applications of BEN in the setting of allogeneic HCT.
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Affiliation(s)
- Jessica Stokes
- Department of Pediatrics, University of Arizona, Tucson, AZ 85721, USA; (J.S.); (M.S.M.); (E.A.H.); (R.J.S.)
| | - Megan S. Molina
- Department of Pediatrics, University of Arizona, Tucson, AZ 85721, USA; (J.S.); (M.S.M.); (E.A.H.); (R.J.S.)
- Department of Immunobiology, University of Arizona, Tucson, AZ 85721, USA
| | - Emely A. Hoffman
- Department of Pediatrics, University of Arizona, Tucson, AZ 85721, USA; (J.S.); (M.S.M.); (E.A.H.); (R.J.S.)
| | - Richard J. Simpson
- Department of Pediatrics, University of Arizona, Tucson, AZ 85721, USA; (J.S.); (M.S.M.); (E.A.H.); (R.J.S.)
- Department of Immunobiology, University of Arizona, Tucson, AZ 85721, USA
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA
- The University of Arizona Cancer Center, Tucson, AZ 85721, USA
| | - Emmanuel Katsanis
- Department of Pediatrics, University of Arizona, Tucson, AZ 85721, USA; (J.S.); (M.S.M.); (E.A.H.); (R.J.S.)
- Department of Immunobiology, University of Arizona, Tucson, AZ 85721, USA
- The University of Arizona Cancer Center, Tucson, AZ 85721, USA
- Department of Medicine, University of Arizona, Tucson, AZ 85721, USA
- Department of Pathology, University of Arizona, Tucson, AZ 85721, USA
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8
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Modified conditioning regimen with idarubicin followed by autologous hematopoietic stem cell transplantation for invasive B-cell non-Hodgkin's lymphoma patients. Sci Rep 2021; 11:4273. [PMID: 33608570 PMCID: PMC7895978 DOI: 10.1038/s41598-021-81944-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 12/28/2020] [Indexed: 12/20/2022] Open
Abstract
High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (ASCT) is still a consolidation treatment choice for relapsed/refractory B-cell non-Hodgkin’s lymphoma (NHL) patients and some aggressive B-cell NHL as frontline therapy. Due to the shortage of carmustine, we switched to idarubicin-substituted BEAC (IEAC) conditioning regimen. We retrospectively compared the outcomes of 72 aggressive B-cell NHL patients treated with IEAC or BEAC regimens followed by ASCT as upfront consolidative treatment. The median time to neutrophil and platelet reconstitution showed no difference between IEAC and BEAC groups. IEAC regimen was well tolerated without increase of adverse events. Transplant-related mortality didn’t occur. The overall survival (OS) and progression-free survival (PFS) of IEAC group (33 and 23 months) were a little longer than that of BEAC group (30 and 18 months). However, due to the small sample numbers, there’s no significant difference in OS and PFS between IEAC and BEAC group with DLBCL or MCL. Multivariate analysis showed that AnnArbor staging, IPI score, lactate dehydrogenase level, remission of disease, modified regimen were related with PFS and OS. In conclusion, IEAC regimen was well tolerated and replacement with idarubicin could be an alternative when carmustine was not available.
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9
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Orfali N, Jhanwar Y, Koo C, Pasciolla M, Baldo M, Cuvilly E, Furman R, Gergis U, Greenberg J, Guarneri D, Hsu JM, Leonard JP, Mark T, Mayer S, Maignan K, Martin P, Opong A, Pearse R, Phillips A, Rossi A, Ruan J, Rutherford SC, Ryan J, Suhu G, Van Besien K, Shore T. Sequential intensive chemotherapy followed by autologous or allogeneic transplantation for refractory lymphoma. Leuk Lymphoma 2021; 62:1629-1638. [PMID: 33586581 DOI: 10.1080/10428194.2021.1881516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We evaluate the safety of bendamustine as a bridge to stem cell transplantation (SCT) in patients with relapsed/refractory lymphoma and residual disease after salvage therapy. Thirty-four subjects without complete responses (CR) received bendamustine 200 mg/m2/day for 2 days followed 14 days later by SCT. Sixteen subjects in partial remission (PR) with maximal FDG-PET SUVs ≤8 prior to bendamustine received autologous SCT, while 13 with suboptimal responses were allografted. Five subjects did not proceed to transplant. No bendamustine toxicities precluded transplantation and no detrimental effect on engraftment or early treatment-related mortality (TRM) was attributable to bendamustine. At 1 year, 75% of auto-recipients and 31% of allo-recipients were alive with CR. Two subjects in the autologous arm developed therapy-related myeloid neoplasia (t-MN). In conclusion, a bendamustine bridge to SCT can be administered without early toxicity to patients with suboptimal responses to salvage chemotherapy. However this approach may increase the risk of t-MN. (NCT02059239).Supplemental data for this article is available online at here.
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Affiliation(s)
- Nina Orfali
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Yuliya Jhanwar
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Calvin Koo
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Michelle Pasciolla
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Maria Baldo
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Edwidge Cuvilly
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Richard Furman
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Usama Gergis
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - June Greenberg
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Danielle Guarneri
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Jing-Mei Hsu
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - John P Leonard
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Tomer Mark
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Sebastian Mayer
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Kathleen Maignan
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Peter Martin
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Adomah Opong
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Roger Pearse
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Adrienne Phillips
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Adriana Rossi
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Jia Ruan
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Sarah C Rutherford
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Jessy Ryan
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Grace Suhu
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Koen Van Besien
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
| | - Tsiporah Shore
- Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA
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10
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Bendamustine-EAM versus BEAM regimen in patients with mantle cell lymphoma undergoing autologous stem cell transplantation in the frontline setting: a multicenter retrospective study from Lymphoma Study Association (LYSA) centers. Bone Marrow Transplant 2020; 55:1076-1084. [PMID: 31953532 DOI: 10.1038/s41409-020-0783-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/29/2019] [Accepted: 01/03/2020] [Indexed: 11/08/2022]
Abstract
The combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) as conditioning regimen prior to autologous stem-cell transplantation (ASCT) remains the standard of care for patients with mantle cell lymphoma (MCL) who are eligible for transplantation. The replacement of carmustine with bendamustine (BeEAM) was described as a promising alternative in non-Hodgkin lymphoma. The aim of this retrospective study was to compare the BeEAM with the BEAM regimen in MCL patients in the frontline setting. Sixty and 108 patients were included in the BeEAM and the BEAM groups, respectively. At 3 years, progression-free survival (PFS) was significantly higher in the BeEAM than in the BEAM group (84% [73-96] vs. 63% [51-79], p = 0.03). The overall survival was not statistically different between the two groups (p = 0.2). In multivariable analysis, BeEAM regimen remained associated with higher PFS (HR = 0.377, 95% CI, 0.146-0.970; p = 0.043). Subgroup analyses in patients treated with prior rituximab-aracytine induction alone showed that BeEAM improved the PFS compared with BEAM regimen (p = 0.04). Despite the high rate of acute renal failure KDIGO III (32%), treatment-related mortality was not increased with the BeEAM regimen. A prospective randomized trial will be necessary to confirm the beneficial effect of the BeEAM regimen in MCL patients undergoing ASCT.
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11
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Ron-Magaña AL, Fernandez-Vargas OE, Barrera-Chairez E, Ron-Guerrero CS, Bañuelos-Ávila AJ. BEAM-Modified Conditioning Therapy with Cisplatin+Dexamethasone Instead of Carmustine Prior to Autologous Hematopoietic Stem Cell Transplantation (HSCT) in Patients with Hodgkin and Non-Hodgkin Lymphoma. Ann Transplant 2019; 24:584-587. [PMID: 31636248 PMCID: PMC6824191 DOI: 10.12659/aot.918259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background High-dose chemotherapy followed by autologous hematopoietic stem cell transplant has proven useful in relapsed or refractory cases of Hodgkin and non-Hodgkin lymphoma. BEAM (carmustine, etoposide, cytarabine, melphalan) is frequently used as a conditioning regimen; however, the high cost and limited availability of BCNU hinders its use in Mexico. Material/Methods Between January 2013 and February 2019, refractory or relapsing HL and NHL patients were treated with an autologous HSCT conditioned with cisplatin+dexamethasone as substitution for BCNU in BEAM. Results Four HL patients and 6 NHL patients were included; 60% were male, the average age was 34.5±15.2 years, the median follow-up was 19.1 months, and 70% had a complete response after transplant. OS at 12 months was 63% for NHL and 100% for HL. Time to hematological recovery was 17.6±2.8 days; all patients developed grade III/IV neutropenia and thrombocytopenia, and 8 patients had transplant-related infections. Conclusions This retrospective study based on real-world data introduces the option of substituting carmustine with cisplatin+dexamethasone, with a similar response, expected lower cost, and better accessibility in developing nations.
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Affiliation(s)
- Ana Lucia Ron-Magaña
- Hemapoietic Stem Cell Transplantation Unit, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.,Department of Hematology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
| | - Omar Eduardo Fernandez-Vargas
- Department of Hematology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.,Department of Physiology, Centro Universitario de Ciencias de la Salud, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Esperanza Barrera-Chairez
- Department of Hematology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.,Department of Physiology, Centro Universitario de Ciencias de la Salud, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | | | - Ana Jaqueline Bañuelos-Ávila
- Hemapoietic Stem Cell Transplantation Unit, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
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12
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Visani G, Loscocco F, Bagaloni I, Ruzzo A, Fuligni F, Graziano F, Magnani M, Isidori A. XRCC1 399GG genotype predicts significantly longer overall survival in resistant lymphoma patients treated with Benda-EAM and ASCT. Bone Marrow Transplant 2019; 55:818-820. [PMID: 31231123 DOI: 10.1038/s41409-019-0572-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/15/2019] [Accepted: 03/28/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Giuseppe Visani
- Hematology and Stem Cell Transplant Center, Marche Nord Hospital, Pesaro, Italy.
| | - Federica Loscocco
- Hematology and Stem Cell Transplant Center, Marche Nord Hospital, Pesaro, Italy
| | - Irene Bagaloni
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy
| | - Annamaria Ruzzo
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy
| | - Fabio Fuligni
- Genetics and Genome Biology, Paediatric Laboratory Medicine (PLM), The Hospital for Sick Children, Toronto, Canada
| | | | - Mauro Magnani
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy
| | - Alessandro Isidori
- Hematology and Stem Cell Transplant Center, Marche Nord Hospital, Pesaro, Italy
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13
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High incidence of reversible renal toxicity of dose-intensified bendamustine-based high-dose chemotherapy in lymphoma and myeloma patients. Bone Marrow Transplant 2019; 54:1923-1925. [PMID: 30890768 DOI: 10.1038/s41409-019-0508-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 12/23/2022]
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14
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Farnault L, Venton G, Pourroy B, Jourde-Chiche N, Ivanov V, Arcani R, Roche P, Mercier C, Colle J, Fanciullino R, Costello RT. Severe renal insufficiency is not an absolute pitfall to autologous stem cell transplantation with BeEAM (bendamustine, etoposide, cytarabine, melphalan) conditioning regimen. Bone Marrow Transplant 2019; 54:1173-1175. [PMID: 30718799 DOI: 10.1038/s41409-019-0467-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/31/2018] [Accepted: 01/22/2019] [Indexed: 11/09/2022]
Affiliation(s)
- L Farnault
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, Marseille, France.
| | - G Venton
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, Marseille, France
| | - B Pourroy
- Pharmacy, ONCOPHARMA Unit, Timone Hospital, University Hospital of Marseille, Marseille, France
| | - N Jourde-Chiche
- Department of Nephrology, La Conception, University Hospital of Marseille, Marseille, France.,UMR_S 1076, Vascular Research Center of Marseille, Marseille, France
| | - V Ivanov
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, Marseille, France
| | - R Arcani
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, Marseille, France
| | - P Roche
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, Marseille, France
| | - C Mercier
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, Marseille, France
| | - J Colle
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, Marseille, France
| | - R Fanciullino
- Pharmacy Unit, La Conception, University Hospital of Marseille, APHM, Marseille, France.,SMARTc Unit, Pharmacokinetics Laboratory, UMR_911 CRO2 AMU, Marseille, France
| | - R T Costello
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, Marseille, France.,Aix Marseille Université, INSERM UMR_S 1090, Technological Advances for Genomics and Clinics, Marseille, France
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15
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Redondo AM, Valcárcel D, González‐Rodríguez AP, Suárez‐Lledó M, Bello JL, Canales M, Gayoso J, Colorado M, Jarque I, Campo R, Arranz R, Terol MJ, Rifón JJ, Rodríguez MJ, Ramírez MJ, Castro N, Sánchez A, López‐Jiménez J, Montes‐Moreno S, Briones J, López A, Palomera L, López‐Guillermo A, Caballero D, Martín A. Bendamustine as part of conditioning of autologous stem cell transplantation in patients with aggressive lymphoma: a phase 2 study from the GELTAMO group. Br J Haematol 2018; 184:797-807. [DOI: 10.1111/bjh.15713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 11/05/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Alba M. Redondo
- Department of Haematology Hospital Universitario de Salamanca ‐ IBSAL CIBERONC Salamanca Spain
| | - David Valcárcel
- Department of Haematology Hospital Vall d'Hebron University Autònoma of Barcelona (UAB) Barcelona Spain
- Experimental Haematology Unit Vall d’ Hebron Institute of Oncology (VHIO) Barcelona Spain
| | | | | | - José L. Bello
- Department of Haematology Complejo Hospitalario Universitario de Santiago (CHUS) Santiago de Compostela Spain
| | | | - Jorge Gayoso
- Department of Haematology Hospital Gregorio Marañón Madrid Spain
| | - Mercedes Colorado
- Department of Haematology Hospital Marqués de Valdecilla Santander Spain
| | - Isidro Jarque
- Department of Haematology Hospital Universitario La Fe CIBERONC Valencia Spain
| | - Raquel Campo
- Department of Haematology Hospital Son Llítzer Palma de Mallorca Spain
| | - Reyes Arranz
- Department of Haematology Hospital de La Princesa Madrid Spain
| | - María J. Terol
- Department of Haematology Hospital Clínico de Valencia Valencia Spain
| | - José J. Rifón
- Department of Haematology Clínica Universitaria de Navarra Pamplona Spain
| | - María J. Rodríguez
- Department of Haematology Hospital Universitario de Canarias Las Palmas de Gran Canaria Spain
| | - María J Ramírez
- Department of Haematology Hospital de Jerez Jerez de la Frontera Spain
| | - Nerea Castro
- Department of Haematology Hospital 12 de Octubre Madrid Spain
| | - Andrés Sánchez
- Department of Haematology Hospital Virgen de la Arrixaca Murcia Spain
| | | | - Santiago Montes‐Moreno
- Department of Pathology Hospital Universitario Marqués de Valdecilla IFIMAV Santander Spain
| | - Javier Briones
- Department of Haematology Hospital Santa Creu i Sant Pau Barcelona Spain
| | - Aurelio López
- Department of Haematology Hospital Arnau de Villanova Valencia Spain
| | - Luis Palomera
- Department of Haematology Hospital Clínico de Zaragoza Zaragoza Spain
| | | | - Dolores Caballero
- Department of Haematology Hospital Universitario de Salamanca ‐ IBSAL CIBERONC Salamanca Spain
| | - Alejandro Martín
- Department of Haematology Hospital Universitario de Salamanca ‐ IBSAL CIBERONC Salamanca Spain
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16
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Norman JE, Schouten HC, Dreger P, Robinson SP. The role of stem cell transplantation in the management of relapsed follicular lymphoma in the era of targeted therapies. Bone Marrow Transplant 2018; 54:787-797. [DOI: 10.1038/s41409-018-0372-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 02/06/2023]
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17
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Olivieri J, Mosna F, Pelosini M, Fama A, Rattotti S, Giannoccaro M, Carli G, Tisi MC, Ferrero S, Sgherza N, Mazzone AM, Marino D, Calimeri T, Loseto G, Saraceni F, Tomei G, Sica S, Perali G, Codeluppi K, Billio A, Olivieri A, Orciuolo E, Matera R, Stefani PM, Borghero C, Ghione P, Cascavilla N, Lanza F, Chiusolo P, Finotto S, Federici I, Gherlinzoni F, Centurioni R, Fanin R, Zaja F. A Comparison of the Conditioning Regimens BEAM and FEAM for Autologous Hematopoietic Stem Cell Transplantation in Lymphoma: An Observational Study on 1038 Patients From Fondazione Italiana Linfomi. Biol Blood Marrow Transplant 2018; 24:1814-1822. [DOI: 10.1016/j.bbmt.2018.05.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/14/2018] [Indexed: 01/17/2023]
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18
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High-dose Benda-EAM versus BEAM in patients with relapsed/refractory classical Hodgkin lymphoma undergoing autologous stem cell transplantation. Bone Marrow Transplant 2018; 54:481-484. [DOI: 10.1038/s41409-018-0328-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 07/20/2018] [Accepted: 08/14/2018] [Indexed: 11/08/2022]
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19
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Yoon JH, Min GJ, Park SS, Jeon YW, Lee SE, Cho BS, Eom KS, Kim YJ, Lee S, Kim HJ, Min CK, Lee JW, Cho SG. Autologous hematopoietic cell transplantation using dose-reduced intravenous busulfan, melphalan, and thiotepa for high-risk or relapsed lymphomas. Bone Marrow Transplant 2018; 54:330-333. [PMID: 30082849 DOI: 10.1038/s41409-018-0289-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/18/2018] [Accepted: 06/21/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Jae-Ho Yoon
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Gi June Min
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Soo Park
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Woo Jeon
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Eun Lee
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung-Sik Cho
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ki-Seong Eom
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoo-Jin Kim
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seok Lee
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hee-Je Kim
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang-Ki Min
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Wook Lee
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seok-Goo Cho
- Department of Hematology, Leukemia Research Institute, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. .,Institute for Translational Research and Molecular Imaging, The Catholic University of Korea College of Medicine, Seoul, Korea.
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20
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Comparable safety profile of BeEAM (bendamustine, etoposide, cytarabine, melphalan) and BEAM (carmustine, etoposide, cytarabine, melphalan) as conditioning before autologous haematopoietic cell transplantation. Contemp Oncol (Pozn) 2018; 22:113-117. [PMID: 30150889 PMCID: PMC6103227 DOI: 10.5114/wo.2018.77046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 03/26/2018] [Indexed: 11/27/2022] Open
Abstract
Introduction BEAM (carmustine, etoposide, cytarabine, melphalan) is the most frequently used high-dose chemotherapy regimen for patients with lymphoma referred for autologous haematopoietic cell transplantation (autoHCT). Recently, a novel conditioning protocol containing bendamustine instead of carmustine (BeEAM) has been proposed to potentially increase the efficacy. Aim of the study The aim of this study was to retrospectively compare the safety profile of BEAM and BeEAM based on single-centre experience. Material and methods A total of 237 consecutive patients with lymphoma treated with either BEAM (n = 174) or BeEAM (n = 63), between the years 2011 and 2016, were included in the analysis. Clinical characteristics of both groups were comparable. Patients with Hodgkin’s lymphoma (HL) constituted 49% of the BEAM group and 40% of the BeEAM group. Results Median time to neutrophil > 0.5 × 109/l recovery was 10 days in both groups (p = 0.29), while median time to platelet > 50 × 109/l recovery was 13 and 14 days after BEAM and BeEAM, respectively (p = 0.12). The toxicity profile was comparable except for arterial hypertension and severe hypokalaemia, which occurred more frequently after BeEAM compared to BEAM (p = 0.02 and p = 0.004, respectively). The rate of early mortality was 1.7% and 1.6%, respectively. The probabilities of the overall and progression-free survival were comparable for both groups (p = 0.73 and p = 0.55, respectively). Conclusions Administration of bendamustine instead of carmustine as part of conditioning does not affect the engraftment or the toxicity profile of the regimen. Therefore, BeEAM may be safely used in patients with lymphoma undergoing autoHCT. Its efficacy requires evaluation in prospective studies.
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21
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Chantepie SP, Garciaz S, Tchernonog E, Peyrade F, Larcher M, Diouf M, Fornecker L, Houot R, Gastinne T, Soussain C, Malak S, Lemal R, Delette C, Ibrahim A, Gac A, Reboursière E, Vilque J, Bekadja M, Casasnovas R, Gressin R, Guidez S, Coso D, Herbaux C, Yakoub‐Agha I, Bouabdallah K, Durot E, Damaj G. Bendamustine-based conditioning prior to autologous stem cell transplantation (ASCT): Results of a French multicenter study of 474 patients from LYmphoma Study Association (LYSA) centers. Am J Hematol 2018; 93:729-735. [PMID: 29473209 DOI: 10.1002/ajh.25077] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/28/2018] [Accepted: 02/21/2018] [Indexed: 11/06/2022]
Abstract
Carmustine shortage has led to an increase use of alternative conditioning regimens prior to autologous stem cell transplantation for the treatment of lymphoma, including Bendamustine-based (BeEAM). The aim of this study was to evaluate the safety of the BeEAM regimen in a large cohort of patients. A total of 474 patients with a median age of 56 years were analyzed. The majority of patients had diffuse large B-cell lymphoma (43.5%). Bendamustine was administered at a median dose of 197 mg/m2 /day (50-250) on days-7 and -6. The observed grade 1-4 toxicities included mucositis (83.5%), gastroenteritis (53%), skin toxicity (34%), colitis (29%), liver toxicity (19%), pneumonitis (5%), and cardiac rhythm disorders (4%). Nonrelapse mortality (NRM) was reported in 3.3% of patients. Acute renal failure (ARF) was reported in 132 cases (27.9%) (G ≥2; 12.3%). Organ toxicities and death were more frequent in patients with post conditioning renal failure. In a multivariate analysis, pretransplant chronic renal failure, bendamustine dose >160 mg/m2 and age were independent prognostic factors for ARF. Pretransplant chronic renal failure, hyperhydration volume, duration of hyperhydration, and etoposide dose were predictive factors of NRM. A simple, four-point scoring system can stratify patients by levels of risk for ARF and may allow for a reduction in the bendamustine dose to avoid toxicity. Drugs shortage may have dangerous consequences. Prospective, comparative studies are needed to confirm the toxicity/efficacy extents from this conditioning regimen compared to other types of high dose therapy.
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Affiliation(s)
| | | | | | | | | | - Momar Diouf
- Clinical Research DepartmentAmiens University hospitalAmiensEA4666 France
| | | | - Roch Houot
- Hematology, University hospitalRennes France
| | - Thomas Gastinne
- Department of HematologyNantes University HospitalNantes France
| | - Carole Soussain
- Department of HematologyCurie Institute, Hôpital René HugueninSaint‐Cloud France
| | - Sandra Malak
- Department of HematologyCurie Institute, Hôpital René HugueninSaint‐Cloud France
| | - Richard Lemal
- Service d'hématologie clinique adulte et de thérapie cellulaire, CHU ESTAING, EA 7453 CHELTER, Université Clermont Auvergne CIC‐501Clermont‐Ferrand France
| | | | | | | | | | - Jean‐Pierre Vilque
- Institut d'Hématologie de Basse‐Normandie, Centre François BaclesseCaen France
| | - Mohamed‐Amine Bekadja
- Hematology and Cell TherapyEtablissement Hospitalier Universitaire (EHU) 1st NovemberOran Algeria
| | | | | | - Stéphanie Guidez
- Oncologie hématologique et thérapie cellulaire, CHU PoitiersPoitiers France
| | - Diane Coso
- Department of HematologyInstitut Paoli CalmettesMarseille
| | - Charles Herbaux
- Hematology, Hôpital HURIEZ UAM allogreffe de CSH, CHRULille France
| | | | | | - Eric Durot
- Department of HematologyCentre Hospitalier UniversitaireReims Cedex FRA
| | - Gandhi Damaj
- Institut d'Hématologie de Basse‐Normandie, CHUCaen France
- Microenvironnement Cellulaire et Pathologies, Normandie Univ, UnicaenMILPAT Caen14000 France
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22
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BEAM vs FEAM high-dose chemotherapy: retrospective study in lymphoma patients undergoing autologous stem cell transplant. Bone Marrow Transplant 2018; 53:1051-1054. [PMID: 29440737 DOI: 10.1038/s41409-018-0120-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 01/07/2018] [Accepted: 01/22/2018] [Indexed: 11/08/2022]
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23
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Saleh K, Danu A, Koscielny S, Legoupil C, Pilorge S, Castilla-Llorente C, Ghez D, Lazarovici J, Michot JM, Khalife-Saleh N, Lapierre V, Alenxandrova K, Arfi-Rouche J, Bourhis JH, Ribrag V. A retrospective, matched paired analysis comparing bendamustine containing BeEAM versus BEAM conditioning regimen: results from a single center experience. Leuk Lymphoma 2017; 59:2580-2587. [DOI: 10.1080/10428194.2017.1403019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Khalil Saleh
- Hematology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Alina Danu
- Hematology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Serge Koscielny
- Biostatistics Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Clémence Legoupil
- Biostatistics Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Sylvain Pilorge
- Hematology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | | | - David Ghez
- Hematology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Julien Lazarovici
- Hematology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Jean-Marie Michot
- Hematology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | | | - Valerie Lapierre
- Hematology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | | | - Julia Arfi-Rouche
- Radiology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | | | - Vincent Ribrag
- Hematology Department, Gustave Roussy Cancer Campus, Villejuif, France
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24
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Joffe E, Rosenberg D, Rozovski U, Perry C, Kirgner I, Trestman S, Gur O, Aviv F, Sarid N, Kolomansky A, Gepstein L, Herishanu Y, Naparstek E. Replacing carmustine by thiotepa and cyclophosphamide for autologous stem cell transplantation in Hodgkin's and non-Hodgkin's B-cell lymphoma. Bone Marrow Transplant 2017; 53:29-33. [PMID: 29035395 DOI: 10.1038/bmt.2017.205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 07/18/2017] [Accepted: 08/12/2017] [Indexed: 11/09/2022]
Abstract
This study aimed to compare the real-life results of TECAM, a thiotepa-based conditioning regimen consisting of thiotepa (40 mg/m2 days -5 to -2), etoposide (200 mg/m2 days -6 to -3), cytarabine (200 mg/m2 days -4 to -1), cyclophosphamide (60 mg/kg day -3), and melphalan (60 mg/m2 days -2 to -1) with that of the conventional carmustine-based regimen BEAM. We reviewed 125 consecutive patients who underwent a first autologous transplantation (ASCT) for B-cell lymphomas at a large tertiary transplantation center between 1999 and 2014. TECAM (n=65) and BEAM (n=60) had comparable results (3yPFS 49 vs 62%, P=0.16; 3yOS 64 vs 71%, P=0.44; TRM 1.6 vs 5%, P=0.35) without a difference in toxicity or time to engraftment. Notably, comparable outcomes were observed even though patients treated with TECAM were older (55 vs 44) and had a trend towards more prior lines of therapy (>2 prior lines: 43 vs 27%, P=0.08). In this regard, 23% of TECAM patients were over the age of 65 yet could withstand therapy with similar results to younger patients. We conclude that, replacing carmustine by thiotepa and cyclophosphamide for ASCT conditioning, has comparable efficacy and safety profiles with a possible advantage in older patients.
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Affiliation(s)
- E Joffe
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Rabin Medical Center, Petah-Tikva, Israel
| | - D Rosenberg
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Rabin Medical Center, Petah-Tikva, Israel
| | - U Rozovski
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Rabin Medical Center, Petah-Tikva, Israel
| | - C Perry
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - I Kirgner
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - S Trestman
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - O Gur
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - F Aviv
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - N Sarid
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - A Kolomansky
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - L Gepstein
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Y Herishanu
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - E Naparstek
- Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
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25
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Carmustine replacement in intensive chemotherapy preceding reinjection of autologous HSCs in Hodgkin and non-Hodgkin lymphoma: a review. Bone Marrow Transplant 2017; 52:941-949. [DOI: 10.1038/bmt.2016.340] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 11/08/2016] [Accepted: 11/16/2016] [Indexed: 11/08/2022]
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26
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Shi Y, Liu P, Zhou S, Yang J, Han X, He X, Zhang C, Gui L, Qin Y, Yang S, Zhao L, Yao J, Jia B, Zhang S, Sun Y, Shi Y. Comparison of CBV, BEAM and BEAC high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation in non-Hodgkin lymphoma: Efficacy and toxicity. Asia Pac J Clin Oncol 2017; 13:e423-e429. [PMID: 28101911 DOI: 10.1111/ajco.12610] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 04/24/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Youwu Shi
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Peng Liu
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Shengyu Zhou
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Jianliang Yang
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Xiaohong Han
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Xiaohui He
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Changgong Zhang
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Lin Gui
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Yan Qin
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Sheng Yang
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Liya Zhao
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Jiarui Yao
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Bo Jia
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Shuxiang Zhang
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Yan Sun
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
| | - Yuankai Shi
- Department of Medical Oncology; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; National Cancer Center / Cancer Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing China
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27
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Gilli S, Novak U, Taleghani BM, Baerlocher GM, Leibundgut K, Banz Y, Zander T, Betticher D, Egger T, Rauch D, Pabst T. BeEAM conditioning with bendamustine-replacing BCNU before autologous transplantation is safe and effective in lymphoma patients. Ann Hematol 2016; 96:421-429. [DOI: 10.1007/s00277-016-2900-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 12/09/2016] [Indexed: 11/29/2022]
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28
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Isidori A, Christofides A, Visani G. Novel regimens prior to autologous stem cell transplantation for the management of adults with relapsed/refractory non-Hodgkin lymphoma and Hodgkin lymphoma: alternatives to BEAM conditioning. Leuk Lymphoma 2016; 57:2499-509. [DOI: 10.1080/10428194.2016.1185785] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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29
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Sellner L, Boumendil A, Finel H, Choquet S, de Rosa G, Falzetti F, Scime R, Kobbe G, Ferrara F, Delmer A, Sayer H, Amorim S, Bouabdallah R, Finke J, Salles G, Yakoub-Agha I, Faber E, Nicolas-Virelizier E, Facchini L, Vallisa D, Zuffa E, Sureda A, Dreger P. Thiotepa-based high-dose therapy for autologous stem cell transplantation in lymphoma: a retrospective study from the EBMT. Bone Marrow Transplant 2016; 51:212-218. [PMID: 26569093 DOI: 10.1038/bmt.2015.273] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 09/28/2015] [Accepted: 09/30/2015] [Indexed: 11/08/2022]
Abstract
Clinical information about thiotepa-based autologous stem cell transplantation (auto-SCT) outside the primary central nervous system lymphoma (PCNSL) field is sparse. In this registry-based retrospective study, we evaluated potential risks and benefits of thiotepa-based preparative regimens compared with BEAM (carmustine, etoposide, cytarabine, melphalan) in auto-SCT for diffuse large B-cell lymphoma (DLBCL, excluding PCNSL), follicular lymphoma (FL) or Hodgkin lymphoma (HL). A total of 14 544 patients (589 thiotepa and 13 955 BEAM) met the eligibility criteria, and 535 thiotepa- and 1031 BEAM-treated patients were matched in a 1:2 ratio for final comparison. No significant differences between thiotepa and BEAM groups for any survival end point were identified in the whole sample or disease entity subsets. For a more detailed analysis, 47 TEAM (thiotepa, etoposide, cytarabine, melphalan)-treated patients were compared with 75 matched BEAM patients with additional collection of toxicity data. Again, there were no significant differences between the two groups for any survival end point. In addition, the frequency of common infectious and non-infectious complications including secondary malignancies was comparable between TEAM and BEAM. These results indicate that thiotepa-based high-dose therapy might be a valuable alternative to BEAM in DLBCL, HL and FL. Further evaluation by prospective clinical trials is warranted.
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Affiliation(s)
- L Sellner
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - A Boumendil
- Lymphoma Working Party, European Society for Blood and Marrow Transplantation, Paris, France
| | - H Finel
- Lymphoma Working Party, European Society for Blood and Marrow Transplantation, Paris, France
| | - S Choquet
- Department of Hematology, Pitié-Salpêtrière Hospital, Paris, France
| | | | | | - R Scime
- Department of Hematology, Azienda Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - G Kobbe
- University Hospital Düsseldorf, Department of Hematology, Oncology and Clinical Immunology, Heinrich Heine University, Düsseldorf, Germany
| | | | - A Delmer
- Service d'Hématologie Clinique, Hôpital Robert Debré, Centre Hospitalier Universitaire (CHU) de Reims, Reims, France
| | - H Sayer
- Department of Hematology and Oncology, Helios Hospital Erfurt, Erfurt, Germany
| | - S Amorim
- APHP, Hopital Saint-louis, Hemato-Oncology Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - R Bouabdallah
- Hematology Department, Paoli Calmettes Institute, Marseille Aix-Marseille University, Marseille, France
| | - J Finke
- Department of Hematology, Freiburg University Medical Center, Freiburg, Germany
| | - G Salles
- Hematologie, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre Bénite, France
| | - I Yakoub-Agha
- LIRIC-U995, Hematology Department and Hematopoietic Stem Cell Transplantation Unit, University-Hospital of Lille, Lille, France
| | - E Faber
- Department of Hemato-Oncology, Faculty Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | | | - L Facchini
- Hematology Unit, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - D Vallisa
- Hematology Unit, Ospedale Civile, Piacenza, Italy
| | - E Zuffa
- Hematology Unit, S Maria delle Croci Hospital, Ravenna, Italy
| | - A Sureda
- Lymphoma Working Party, European Society for Blood and Marrow Transplantation, Paris, France
- Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain
| | - P Dreger
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Lymphoma Working Party, European Society for Blood and Marrow Transplantation, Paris, France
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30
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Musso M, Messina G, Di Renzo N, Di Carlo P, Vitolo U, Scalone R, Marcacci G, Scalzulli PR, Moscato T, Matera R, Crescimanno A, Santarone S, Orciuolo E, Merenda A, Pavone V, Pastore D, Donnarumma D, Carella AM, Ciochetto C, Cascavilla N, Mele A, Lanza F, Di Nicola M, Bonizzoni E, Pinto A. Improved outcome of patients with relapsed/refractory Hodgkin lymphoma with a new fotemustine-based high-dose chemotherapy regimen. Br J Haematol 2016; 172:111-21. [PMID: 26458240 PMCID: PMC5053328 DOI: 10.1111/bjh.13803] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 08/03/2015] [Indexed: 01/04/2023]
Abstract
High-dose chemotherapy (HDT) with autologous stem cell transplantation is the standard of care for relapsed/refractory (RR) Hodgkin lymphoma (HL). Given that HDT may cure a sizeable proportion of patients refractory to first salvage, development of newer conditioning regimens remains a priority. We present the results of a novel HDT regimen in which carmustine was substituted by a third-generation chloroethylnitrosourea, fotemustine, with improved pharmacokinetics and safety (FEAM; fotemustine, etoposide, cytarabine, melphalan) in 122 patients with RR-HL accrued into a prospective registry-based study. Application of FEAM resulted in a 2-year progression-free survival (PFS) of 73·8% [95% confidence interval (CI), 0·64-0·81] with median PFS, overall survival and time to progression yet to be reached. The 2-year risk of progression adjusted for the competitive risk of death was 19·4% (95% CI, 0·12-0·27) for the entire patient population. Most previously established independent risk factors, except for fluorodeoxyglucose ((18) (F) FDG)-uptake, were unable to predict for disease progression and survival after FEAM. Although 32% of patients had (18) (F) FDG-positrin emission tomography-positive lesions before HDT, the 2-year risk of progression adjusted for competitive risk of death was 19·4% (95% CI; 0·12-0·27). No unusual acute toxicities or early/late pulmonary adverse events were registered. FEAM emerges as an ideal HDT regimen for RR-HL patients typically pre-exposed to lung-damaging treatments.
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Affiliation(s)
- Maurizio Musso
- Dipartimento Oncologico “La Maddalena”UOC di Oncoematologia e TMOPalermoItaly
| | - Giuseppe Messina
- Azienda Ospedaliera ‘Bianchi Melacrino Morelli’C.T.M.O. Centro Unico Regionale Trapianti di Cellule Staminali e Terapie CellulariReggio CalabriaItaly
| | - Nicola Di Renzo
- UOC di Ematologia e Trapianto di Cellule StaminaliP.O. “Vito Fazzi”LecceItaly
| | - Paolo Di Carlo
- Unità Terapia Intensiva Ematologica per il Trapianto EmopoieticoOspedale CivilePescaraItaly
| | - Umberto Vitolo
- Dipartimento di Oncologia ed EmatologiaA.O. U.Città della Salute e della Scienza di Torino San Giovanni BattistaS.C. EmatologiaTorinoItaly
| | - Renato Scalone
- Dipartimento Oncologico “La Maddalena”UOC di Oncoematologia e TMOPalermoItaly
| | - Gianpaolo Marcacci
- Dipartimento di EmatologiaIstituto Nazionale TumoriFondazione ‘G. Pascale’IRCCSUOC di Ematologia Oncologica e Trapianto di Cellule StaminaliNapoliItaly
| | - Potito R. Scalzulli
- Divisione di EmatologiaIRCSS Casa Sollievo della SofferenzaSan Giovanni RotondoItaly
| | - Tiziana Moscato
- Azienda Ospedaliera ‘Bianchi Melacrino Morelli’C.T.M.O. Centro Unico Regionale Trapianti di Cellule Staminali e Terapie CellulariReggio CalabriaItaly
| | - Rossella Matera
- UOC di Ematologia e Trapianto di Cellule StaminaliP.O. “Vito Fazzi”LecceItaly
| | | | - Stella Santarone
- Unità Terapia Intensiva Ematologica per il Trapianto EmopoieticoOspedale CivilePescaraItaly
| | - Enrico Orciuolo
- Dipartimento di Oncologia, Trapianti e Tecnologie AvanzateAzienda Ospedaliero‐Universitaria PisanaPisaItaly
| | - Anxur Merenda
- ARNAS Ospedale Civico BenfratelliU.O. di EmatologiaPalermoItaly
| | - Vincenzo Pavone
- Ospedale Generale Provinciale “Cardinale G. Panico”S.C. di Ematologia e Trapianto di Cellule StaminaliTricase, LecceItaly
| | | | - Daniela Donnarumma
- Dipartimento di EmatologiaIstituto Nazionale TumoriFondazione ‘G. Pascale’IRCCSUOC di Ematologia Oncologica e Trapianto di Cellule StaminaliNapoliItaly
| | - Angelo M. Carella
- U.O. Complessa di EmatologiaIRCCS Azienda Ospedaliera Universitaria San Martino‐ISTGenovaItaly
| | - Chiara Ciochetto
- Dipartimento di Oncologia ed EmatologiaA.O. U.Città della Salute e della Scienza di Torino San Giovanni BattistaS.C. EmatologiaTorinoItaly
| | - Nicola Cascavilla
- Divisione di EmatologiaIRCSS Casa Sollievo della SofferenzaSan Giovanni RotondoItaly
| | - Anna Mele
- Ospedale Generale Provinciale “Cardinale G. Panico”S.C. di Ematologia e Trapianto di Cellule StaminaliTricase, LecceItaly
| | - Francesco Lanza
- Unità Operativa di EmatologiaIstituti Ospitalieri di CremonaCremonaItaly
| | - Massimo Di Nicola
- Dipartimento di Oncologia MedicaFondazione IRCCS Istituto Nazionale TumoriMilanoItaly
| | - Erminio Bonizzoni
- Sezione di Statistica Medica e Biometria ‘GA Maccaro’Dipartimento di Scienze Cliniche e di ComunitàUniversità di MilanoMilanoItaly
| | - Antonello Pinto
- Dipartimento di EmatologiaIstituto Nazionale TumoriFondazione ‘G. Pascale’IRCCSUOC di Ematologia Oncologica e Trapianto di Cellule StaminaliNapoliItaly
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Garciaz S, Coso D, Schiano de Collela JM, Broussais F, Stoppa AM, Aurran T, Chabannon C, Helvig A, Xerri L, Blaise D, Bouabdallah R. Bendamustine-based conditioning for non-Hodgkin lymphoma autologous transplantation: an increasing risk of renal toxicity. Bone Marrow Transplant 2015; 51:319-21. [PMID: 26524266 DOI: 10.1038/bmt.2015.257] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- S Garciaz
- Cancer Center Institut J. Paoli-I. Calmettes-Université de la Méditerranée, Marseille, France
| | - D Coso
- Cancer Center Institut J. Paoli-I. Calmettes-Université de la Méditerranée, Marseille, France
| | - J-M Schiano de Collela
- Cancer Center Institut J. Paoli-I. Calmettes-Université de la Méditerranée, Marseille, France
| | - F Broussais
- Cancer Center Institut J. Paoli-I. Calmettes-Université de la Méditerranée, Marseille, France
| | - A-M Stoppa
- Cancer Center Institut J. Paoli-I. Calmettes-Université de la Méditerranée, Marseille, France
| | - T Aurran
- Cancer Center Institut J. Paoli-I. Calmettes-Université de la Méditerranée, Marseille, France
| | - C Chabannon
- Cancer Center Institut J. Paoli-I. Calmettes-Université de la Méditerranée, Marseille, France
| | - A Helvig
- Cancer Center Institut J. Paoli-I. Calmettes-Université de la Méditerranée, Marseille, France
| | - L Xerri
- Cancer Center Institut J. Paoli-I. Calmettes-Université de la Méditerranée, Marseille, France
| | - D Blaise
- Cancer Center Institut J. Paoli-I. Calmettes-Université de la Méditerranée, Marseille, France
| | - R Bouabdallah
- Cancer Center Institut J. Paoli-I. Calmettes-Université de la Méditerranée, Marseille, France
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32
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Isidori A, Clissa C, Loscocco F, Guiducci B, Barulli S, Malerba L, Gabucci E, Visani G. Advancement in high dose therapy and autologous stem cell rescue in lymphoma. World J Stem Cells 2015; 7:1039-1046. [PMID: 26328019 PMCID: PMC4550627 DOI: 10.4252/wjsc.v7.i7.1039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 01/27/2015] [Accepted: 07/17/2015] [Indexed: 02/06/2023] Open
Abstract
Although advanced stage aggressive non-Hodgkin’s lymphomas and Hodgkin’s disease are thought to be chemotherapy-responsive cancers, a considerable number of patients either relapse or never attain a remission. High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) is often the only possibility of cure for most of these patients. However, many controversial issues still remain with respect to HDT/ASCT for lymphomas, including its role for, the optimal timing of transplantation, the best conditioning regimen and the potential use of localized radiotherapy or immunologic methods to decrease post-transplant recurrence. Recently, mainly due to the unavailability of carmustine, several novel conditioning protocols have been clinically developed, with the aim of improving the overall outcome by enhancing the anti-lymphoma effect and, at the same time, by reducing short and long-term toxicity. Furthermore, the better safety profiles of novel approaches would definitively allow patients aged more than 65-70 years to benefit from this therapeutic option. In this review, we will briefly discuss the most relevant and recent data available regarding HDT/ASCT in lymphomas.
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33
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Tardy MP, Gastaud L, Ojeda-Uribe M, Boscagli A, Caruso S, Skaf R, Gutnecht J, Thyss A, Peyrade F. Z-BeEAM (Ibritumomab tiuxetan, Bendamustine, Etoposide, Cytarabine, Melphalan) before autologous stem cell transplantation is safe and efficient for refractory large B-cell lymphoma. Exp Hematol Oncol 2015; 4:18. [PMID: 26185733 PMCID: PMC4504161 DOI: 10.1186/s40164-015-0013-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/23/2015] [Indexed: 11/21/2022] Open
Abstract
Background Refractory or relapsed large B-cells lymphoma are usually treated with a high dose chemotherapy regimen followed by an autolougous stem cells transplantation. BEAM (carmustine, etoposide, cytarabine, melphalan) or more recently Z-BEAM (ibritumomab tiuxetan and BEAM) are commonly used regimens, but recently carmustine availability became difficult. The purpose of this study was to evaluate the feasibility and the safety of replacing carmustine by bendamustine in a new Z-BeEAM regimen (ibritumomab tiuxetan, bendamustine, etoposide, cytarabine, melphalan) prior to autologous stem cell transplantation. Findings This study was a retrospective analyze of six patients, with a median age of 60, treated by Z-BeEAM before autologous stem cell transplantation. We did not put in evidence any additional toxicities compared to conventional induction chemotherapy. The main toxicities were mucositis (3 grade III among 6 patients), gastrointestinal (2 grade III vomiting and 2 grade III diarrhea) and neutropenia (6 grade IV). Engraftment was successfully achieved for all patients. At the time of analysis of this study all patients were alive and in complete response based on the PET-CT evaluation. Conclusions BeEAM plus ibritumomab tiuxetan combined regimen before autologous stem cell transplantation is feasible and safe in aggressive relapsing large B-cell lymphoma.
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Affiliation(s)
- Magalie P Tardy
- Department of Oncology, Antoine-Lacassagne Center, Nice, France
| | - Lauris Gastaud
- Department of Oncology, Antoine-Lacassagne Center, Nice, France
| | | | - Annick Boscagli
- Department of Oncology, Antoine-Lacassagne Center, Nice, France
| | | | - Richard Skaf
- Department of Oncology, Saint-Georges Clinic, Nice, France
| | - Jean Gutnecht
- Department of Oncology, Frejus-Saint Raphael Hospital, Frejus, France
| | - Antoine Thyss
- Department of Oncology, Antoine-Lacassagne Center, Nice, France
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