BeEAM (bendamustine, etoposide, cytarabine, melphalan) before autologous stem cell transplantation is safe and effective for resistant/relapsed lymphoma patients
- 22 September 2011
- journal article
- research article
- Published by American Society of Hematology in Blood
- Vol. 118 (12), 3419-3425
- https://doi.org/10.1182/blood-2011-04-351924
Abstract
We designed a phase 1-2 study to evaluate the safety and the efficacy of increasing doses of bendamustine (160 mg/m2, 180 mg/m2, and 200 mg/m2 given on days −7 and −6) coupled with fixed doses of etoposide, cytarabine, and melphalan (BeEAM regimen) as the conditioning regimen to autologous stem cell transplantation for resistant/relapsed lymphoma patients. Forty-three patients (median age, 47 years) with non-Hodgkin (n = 28) or Hodgkin (n = 15) lymphoma were consecutively treated. Nine patients entered the phase 1 study; no patients experienced a dose-limiting toxicity. Thirty-four additional patients were then treated in the phase 2. A median number of 6 × 106 CD34+ cells/kg (range, 2.4-15.5) were reinfused. All patients engrafted, with a median time to absolute neutrophil count > 0.5 × 109/L of 10 days. The 100-day transplantation-related mortality was 0%. After a median follow-up of 18 months, 35 of 43 patients (81%) are in complete remission, whereas 6 of 43 relapsed and 2 of 43 did not respond. Disease type (non-Hodgkin lymphomas vs Hodgkin disease) and disease status at transplantation (chemosensitive vs chemoresistant) significantly influenced DFS (P = .01; P = .007). Remarkably, 4 of 43 (9%) patients achieved the first complete remission after receiving the high-dose therapy with autologous stem cell transplantation. In conclusion, the new BeEAM regimen is safe and effective for heavily pretreated lymphoma patients. The study was registered at European Medicines Agency (EudraCT number 2008-002736-15).Keywords
This publication has 39 references indexed in Scilit:
- Salvage Regimens With Autologous Transplantation for Relapsed Large B-Cell Lymphoma in the Rituximab EraJournal of Clinical Oncology, 2010
- Salvage Therapy for Relapsed/Refractory Diffuse Large B Cell LymphomaTransplantation and Cellular Therapy, 2008
- Autotransplant conditioning regimens for aggressive lymphoma: are we on the right road?Bone Marrow Transplantation, 2007
- A phase I study of bendamustine hydrochloride administered day 1+2 every 3 weeks in patients with solid tumoursBritish Journal of Cancer, 2007
- Revised Response Criteria for Malignant LymphomaJournal of Clinical Oncology, 2007
- Autologous stem cell transplantation for clinically aggressive non-Hodgkin's lymphoma: the role of preparative regimensBone Marrow Transplantation, 2001
- Regimen-related toxicity and non-relapse mortality with high-dose cyclophosphamide, carmustine (BCNU) and etoposide (VP16-213) (CBV) and CBV plus cisplatin (CBVP) followed by autologous stem cell transplantation in patients with Hodgkin’s diseaseBone Marrow Transplantation, 1999
- BEAM chemotherapy followed by autologous stem cell support in lymphoma patients: analysis of efficacy, toxicity and prognostic factorsBone Marrow Transplantation, 1997
- Autologous Bone Marrow Transplantation as Compared with Salvage Chemotherapy in Relapses of Chemotherapy-Sensitive Non-Hodgkin's LymphomaNew England Journal of Medicine, 1995
- High-Dose Therapy and Autologous Bone Marrow Transplantation after Failure of Conventional Chemotherapy in Adults with Intermediate-Grade or High-Grade Non-Hodgkin's LymphomaNew England Journal of Medicine, 1987