Faculty Collaboration Database

BEAM or BUCYVP16-conditioning regimen for autologous stem-cell transplantation in non-Hodgkin's lymphomas. Bone Marrow Transplant 2019 Oct;54(10):1553-1561

Date

02/06/2019

Pubmed ID

30718797

DOI

10.1038/s41409-019-0463-y

Scopus ID

2-s2.0-85061046839 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

High-dose chemotherapy followed by autologous hematopoietic cell transplantation (AHCT) is an effective salvage therapy for patients with relapsed chemosensitive non-Hodgkin's lymphoma (NHL). However, the optimal conditioning regimen is unclear. Different conditioning regimens prior to AHCT have been used with the two most common being BEAM (carmustine, etoposide, cytarabine, and melphalan) and BUCYVP16 (busulfan, cyclophosphamide, and etoposide). We sought to compare the two regimens for patients with relapsed NHL undergoing AHCT. We retrospectively compared the outcomes of patients treated with BEAM (N = 269) at The Ohio State University and BUCYVP16 (N = 409) at the Cleveland Clinic followed by AHCT between 2006 and 2014. The primary endpoints were progression-free survival (PFS), overall survival (OS), and cumulative incidence of relapse (CIR). Patient characteristics between the two groups were similar. After a median follow-up of 3.9 years for BEAM and 4.3 years for BUCYVP16 from AHCT, the rate of relapse (p = 0.69), PFS (p = 0.52), and OS (p = 0.11) were similar between the two conditioning regimens. No differences in survival outcomes were seen in disease subtypes. Multivariable analysis showed significant association toward improved OS with BEAM (HR: 1.56, 95% CI 1.16-2.10) (p < 0.01). Even though the study is limited by its retrospective nature and some differences in cohort, the findings indicate that BEAM could serve as an alternative conditioning regimen prior to AHCT for NHL.

Author List

Singer S, Sharma N, Dean R, Zhao Q, Abounader D, Elder P, Hofmeister CC, Benson DM, Rosko A, Penza S, Andritsos L, Vasu S, Jaglowski S, William BM, Bolwell B, Pohlman B, Kalaycio M, Jagadeesh D, Hill B, Sobecks R, Devine SM, Majhail NS, Efebera YA

Author

Samantha M. Jaglowski MD, MPH Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Carmustine
Cytarabine
Female
Humans
Lymphoma, Non-Hodgkin
Male
Melphalan
Middle Aged
Podophyllotoxin
Retrospective Studies
Stem Cell Transplantation
Transplantation, Autologous
Young Adult