scholarly journals High Dose Chemotherapy and Autologous Stem Cell Transplantation in Non-Hodgkin's Lymphoma: an Eight-Year Experience

2006 ◽  
Vol 47 (5) ◽  
pp. 604 ◽  
Author(s):  
Hyun Chang ◽  
June-Won Cheong ◽  
Jee-Sook Hahn
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Hodgkin’S Lymphoma ◽  
High Dose Chemotherapy ◽  
Hodgkin's Lymphoma ◽  
High Dose ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

BEAM or BuCyE high-dose chemotherapy followed by autologous stem cell transplantation in non-Hodgkin's lymphoma patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7097-7097
Author(s):  
J. Kim ◽  
E. Kim ◽  
B. Sohn ◽  
D. Yoon ◽  
C. Yoo ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Hodgkin’S Lymphoma ◽  
High Dose Chemotherapy ◽  
Hodgkin's Lymphoma ◽  
High Dose ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

7097 Background: The objective of this study was to compare the efficacy and toxicity of two high-dose regimens for autologous stem cell transplantation (ASCT) in patients with non-Hodgkin's lymphoma (NHL): BEAM (BCNU, etoposide, cytarabine, and melphalan) and BuCyE (busulfan, cyclophosphamide, and etoposide). Methods: We analysed 65 NHL patients, who underwent high-dose chemotherapy with BEAM (N=43) or BuCyE (N=22), followed by ASCT, at the Asan Medical Center. BEAM was used from February 2002 to October 2005, and BuCyE was used from November 2005 to April 2008. Results: Median age was 46 years (range: 15–68), and baseline characteristics, such as gender, International Prognostic Index (IPI), age adjusted IPI, stage and status of disease at ASCT, and median number of infused CD 34+cells/kg were well balanced between groups. The incidence of mucositis, nausea/vomiting, diarrhea and bleeding, and the number of events clinically important infections during ASCT did not differ between groups. Median follow-up for survivors was 49.3 months in the BEAM group and 21.5 months in the BuCyE group. Median overall survival (OS) was 30.6 months (95% confidence interval [CI], 8.19–53.0 months) and 22.6 months (95% CI, 12.1–33.1 months) and median event-free survival (EFS) was 16.1 months (95% CI, 0.0–53.6 months) and 11.2 months (95% CI, 0.0–22.5 months) in the BEAM and BuCyE group, respectively. There were no significant differences in OS (p=0.636) and EFS (p=0.575) between the two groups. Conclusions: In our analysis, BuCyE appeared to be not inferior to BEAM for survival. And we found that regimen-related toxicities did not differ significantly between the two groups. No significant financial relationships to disclose.

Busulfan, Melphalan and Etoposide Followed by Autologous Stem Cell Transplantation on Patients with Non-Hodgkin's Lymphoma: Multicenter Study From Consortium for Improving Survival of Lymphoma (CISL) in Korea

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2021-2021
Author(s):  
Kyoung Ha Kim ◽  
Won Seog Kim ◽  
Sung-Kyu Park ◽  
Mark Hong Lee ◽  
Sang Kyun Sohn ◽  
...  
Keyword(s):  
Stem Cell ◽  
High Risk ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Hodgkin’S Lymphoma ◽  
High Dose Chemotherapy ◽  
Hodgkin's Lymphoma ◽  
High Dose ◽  
Non Hodgkin's Lymphoma

Abstract Abstract 2021 Background: High dose chemotherapy followed by autologous stem cell transplantation (ASCT) has become the standard approach for relapsed or high risk non-Hodgkin's lymphoma (NHL). Several different high dose therapy (HDT) conditioning regimens have been used for non-Hodgkin's lymphoma (NHL), such as BEAM (carmustine, etoposide, cytosine arabinoside, melphalan), BEAC (carmustine, etoposide, cytosine arabinoside, cyclophosphamide), and CBV (cyclophosphamide, carmustine, etoposide). Carmustine is an active drug in the HDT of NHL but the supply of carmustine is limited in some countries including Korea. Intravenous busulfan containing regimens as conditioining regimen have been used for both allogeneic and autologous stem cell transplantation in patients with hematologic and non –hematologic malignancies. The purpose of this prospective multicenter phase II study was evaluate the efficacy and safety of iv busulfan/melphalan/etoposide regimen as a conditioining regimen for high dose chemotherapy in the patients with relapsed or high risk NHL. Methods: Patients with relapsed or primary refractory NHL or chemosensitive high risk NHL underwent high dose chemotherapy followed by ASCT at 13 centers in Korea. The conditioning regimen consisted of iv busulfan 3.2mg/kg/day i.v. on days −8, −7 and −6, etoposide 400mg/m2/day i.v. on days −5 and −4 and melphalan 50mg/m2/day i.v. on days −3 and −2. Results: Fifty one patients were enrolled onto the study. Main subgroups were DLBCL (n=25, 49%) and T cell lymphoma (n=19, 37%). At the time of ASCT, the disease status of patients was as follows: 13 patients were high risk in remission, 16 were primarily refractory to inducton therapy, 15 patients were in chemosensitive relapse. All patients had successful stem cell engraftment with a median time to neutrophil recovery of more than 500/mm3 of 10 days (range, 2 to 30 days). Platelet recovery of more than 20,000/mm3 was seen after a median of 10 days (range, 2 to 51 days) with delayed recovery in one patient. Treatment related toxicities included nausea/vomiting in 28 patients (55%), diarrhea in 28 patients (55%) and mucositis in 33 patients (65%), which were grade I or II in the majority of cases. Grade I/II hepatic toxicities occurred in 24% (n=12) and grade III in 6% (n=3). There were no VOD and treatment related death. The median duration of hospitalization for ASCT was 30 days (range, 12 to 80 days). Forty one patients (80%) achieved a complete response 1 month after ASCT, while three patients showed progressive disease. At a median follow up of 14.7 months, 21(41%) patients exhibited a relapse or progression, while 11 patients had died of disease and one patient had died of heart failure. The estimated 2-year overall and progression free survival for all patients was 64% and 40%, respectively. Conclusion: This preliminary analysis suggests that conditioning regimen of i.v. busulfan/melphalan/etoposide would be well tolerated and effective in patients with relapsed or high risk NHL. Accordingly, this regimen may be regarded as an important treatment option to substitute for BEAM regimen. Disclosures: Lee: Novartis: Research Funding.

Phase II Trial of a Transplantation Regimen of Yttrium-90 Ibritumomab Tiuxetan and High-Dose Chemotherapy in Patients With Non-Hodgkin's Lymphoma

2008 ◽  
Vol 26 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Amrita Krishnan ◽  
Auayporn Nademanee ◽  
Henry C. Fung ◽  
Andrew A. Raubitschek ◽  
Arturo Molina ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
High Dose ◽  
Ibritumomab Tiuxetan ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Purpose This phase II trial evaluated the safety and efficacy of combining yttrium-90 (90Y) ibritumomab tiuxetan with high-dose carmustine, cytarabine, etoposide, and melphalan (BEAM) and autologous stem-cell transplantation in patients with non-Hodgkin's lymphoma who were considered ineligible for total-body irradiation because of older age or prior radiotherapy. Patients and Methods Between May 2002 and January 2006, 14 days before autologous stem-cell transplantation, 41 patients with non-Hodgkin's lymphoma received standard-dose 90Y ibritumomab tiuxetan (14.8 MBq/kg [0.4 mCi/kg]) followed by high-dose BEAM. Results The median age was 60 years (range, 19 to 78 years), and the median number of previous therapies was two (range, one to six). Disease histologies were diffuse large B-cell (n = 20), mantle cell (n = 13), follicular (n = 4), and transformed lymphoma (n = 4). With a median follow-up of 18.4 months (range, 5.5 to 53.3 months) the estimated 2-year overall and progression-free survival were 88.9% (95% CI, 75.3% to 95.2%) and 69.8% (95% CI, 56.4% to 79.7%). The median time to WBC engraftment was 11 days (range, 9 to 26 days) and time to platelet engraftment was 12 days (range, 3 to 107 days). Adverse events were similar to those seen historically with high-dose BEAM alone, and included grade 3 or 4 pulmonary toxicity in 10 patients. Conclusion Adding 90Y ibritumomab tiuxetan to high-dose BEAM with autologous stem-cell transplantation is feasible and has a toxicity and tolerability profile similar to that observed with BEAM alone. Rates of progression-free survival seen in these patients are promising and warrant additional study.

BEAC or BEAM Chemotherapy Followed by Autologous Stem Cell Transplantation in Non-Hodgkin’s Lymphoma Patients: Comparative Analysis on Efficacy and Toxicity.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5291-5291
Author(s):  
Ja Eun Koo ◽  
Shin Kim ◽  
Ock Bae Ko ◽  
Danbi Lee ◽  
Young Pill Chong ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
High Dose ◽  
Who Grade ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Abstract Background: Non-Hodgkin’s lymphoma (NHL) is the major indication of high dose chemotherapy (HDC) followed by autologous stem cell transplantation (ASCT). However, little is known on the comparative efficacy and toxicity of various HDC regimens. Aims: This study aimed to compare the efficacy and toxicity of BEAC and BEAM regimen. Methods: Between April 1994 and February 2005, 97 NHL patients were received HDC with BEAC (N=69) or BEAM (N=28) followed by ASCT at Asan Medical Center. We matched one patient received BEAM with two patients received BEAC who has same International Prognostic Index (IPI). Thus total 84 patients (56 in BEAC group and 28 in BEAM group) were analyzed. Results: Of 84 patients, 55 (65.5%) were male, 29 (34.5%) were female and median age was 40.5 (15–65) years. Baseline characteristics such as age, sex, disease status at ASCT, histology, stage at ASCT, IPI were not different between two groups. Time to neutrophil engraftment (WBC>0.5′109/mm3) was significantly longer in BEAC group (14.5days) than in BEAM group (11.0days, p=0.002). Total amount of RBC transfusion was more in BEAC group than in BEAM group (6.5 units vs. 3.7 units, p=0.037). Time to platelet engraftment (platelet>20′109/mm3) and total amount of platelet transfusion were different between two groups. Patients received BEAM had more frequent WHO grade ≥ 2 diarrhea than those received BEAC (46.4% vs. 19.6%, p=0.010). But, other clinically important toxicity such as mucositis, nausea/vomiting, bleeding were not different between two groups. In addition, neutropenic fever and documented infection were not different between two groups. Two year overall survival (OS) rate was 30% in BEAC group and 66% in BEAM group. Two year event free survival (EFS) rate was 34% in BEAC group and 61% in BEAM group. Both OS and EFS was significantly superior in BEAM group than in BEAC group (p=0.049, p=0.032, respectively). Summary/Conclusions: BEAM appears to be a superior HDC regimen in the aspect of OS and EFS than BEAC while regimen related toxicity is similar except more frequent diarrhea in BEAM.

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