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1.
Leuk Lymphoma ; 64(13): 2178-2187, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37615123

ABSTRACT

The combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) followed by autologous stem cell transplantation (ASCT) is a commonly used intensification regimen for patients with Hodgkin lymphoma. As etoposide and cytarabine dosing are not defined, we conducted a retrospective, multicenter study, to compare efficacy and toxicity in 130 patients with Hodgkin lymphoma receiving etoposide and cytarabine at either 200 mg/m2/d (n = 50), 400 mg/m2/d (n = 35), or etoposide 200 mg/m2/d and cytarabine 400 mg/m2/d (n = 45). Progression-free survival and overall survival were not associated with the intensity of conditioning. Increased conditioning intensity was associated with longer duration of thrombocytopenia, a higher number of transfused RBC and platelet units and a higher frequency of mucositis, but serious adverse events or infectious complications were not increased. The intensity of BEAM regimen was not associated with survival but with the rate of cytopenia and mucositis advocating for the use of lower dosing in frail patients.


Subject(s)
Hematopoietic Stem Cell Transplantation , Hodgkin Disease , Mucositis , Humans , Hodgkin Disease/diagnosis , Hodgkin Disease/therapy , Etoposide/adverse effects , Retrospective Studies , Hematopoietic Stem Cell Transplantation/adverse effects , Mucositis/chemically induced , Transplantation, Autologous , Cytarabine/adverse effects , Carmustine/adverse effects , Melphalan/adverse effects , Antineoplastic Combined Chemotherapy Protocols/adverse effects
2.
Ann Hematol ; 102(8): 2225-2231, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37380715

ABSTRACT

High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is part of the treatment strategy for some patients with high-risk lymphoma by improving survival with an acceptable toxicity profile. Although the BEAM (BCNU, etoposide, cytarabine, and melphalan) intensification regimen is the most used, the optimal dosing for each drug is unclear. Here, we retrospectively compared the outcome of 110 patients receiving higher (400 mg/m2, n = 69) or lower (200 mg/m2, n = 41) etoposide and cytarabine doses in our institution between 2012 and 2019. Patients in the BEAM 200 group experienced less toxicity with reduced fever duration (P < 0.001), number of platelet transfusions (P = 0.008), antibiotic duration (P < 0.001), antifungal therapy (P < 0.001), and mucositis (P < 0.001) whereas length of stay, admission to the intensive care unit, and in-hospital mortality were not different between groups. Progression-free survival (PFS) was non-significantly lower in the BEAM 200 group (36-month PFS, 68% vs. 80%, P = 0.053) whereas OS was similar between the two groups (36-month OS, 87% vs. 91%, respectively, P = 0.12). Albeit a non-significant reduction in PFS, BEAM 200 conditioning intensity was associated with a reduced toxicity profile.


Subject(s)
Hematopoietic Stem Cell Transplantation , Lymphoma , Humans , Cytarabine , Hematopoietic Stem Cell Transplantation/adverse effects , Etoposide , Retrospective Studies , Carmustine , Transplantation, Autologous , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Lymphoma/drug therapy , Melphalan , Transplantation Conditioning
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