Background: High-dose chemotherapy (HDC) followed by autologous stem cell transplantation (ASCT) is a widely used treatment modality in patients with malignant lymphoma. However, limited data are available on the comparison of toxicity and efficacy of different HDC regimens applied in malignant lymphoma. Herein, we performed a retrospective study to evaluate the efficacy and toxicity of modified BuCy (mBuCy) (semustine, cytarabine, busulfan, and cyclophosphamide) and BEAM (semustine, etoposide, cytarabine, and melphalan) regimens.

Patients and Methods: From February 2014 to April 2017, a total of 58 Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL) patients underwent HDC with mBuCy (n=19) or BEAM (n=39), followed by ASCT in our center. In our study, the two groups were matched by the same disease status at time of the ASCT (ratio, 1:1). In total, 19 pairs patients were analyzed.

Results: The characteristics of the patients between the two groups were similar (p >0.05). There were no significant differences in median number of infused CD34+ cells/kg, median units of transfused red blood cells and platelets, and hospitalization duration between two groups. The median time of platelet engraftment did not differ between the two groups (p=0.274). However, the median time of neutrophil engraftment was significantly shorter in the mBuCy group than in the BEAM group (median days: 9 days VS 10 days, p=0.004). When it comes to toxicity, the incidence of nausea/vomiting, mucositis, diarrhea, hepatic impairment, renal impairment, pulmonary infection and treatment-related mortality was found to be similar in the two groups. With a median follow-up of 7.6 months (range, 0.8-30.9months) in the mBuCy group and 20.3 months (range, 0.4-35.8 months) in the BEAM group, the 2-year OS of the regimens mBuCy and BEAM were 86.0% and 66.0% respectively (p=0.245). The 2-year PFS of the regimens mBuCy and BEAM were 79.0% and 53.0% respectively (p=0.205).

Conclusion:These findings suggested that mBuCy conditioning regimen is equivalent to BEAM conditioning regimen and the conditioning regimen of mBuCy was well tolerated and seemed to be effective in patients with malignant lymphoma.

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Disclosures

No relevant conflicts of interest to declare.

Topics:
autologous stem cell transplant, lymphoma, toxic effect, cytarabine, semustine, busulfan, chemotherapy regimen, cyclophosphamide, diarrhea, etoposide

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2017 by The American Society of Hematology
2017
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