Bendamustine-EAM versus BEAM regimen in patients with mantle cell lymphoma undergoing autologous stem cell transplantation in the frontline setting: a multicenter retrospective study from Lymphoma Study Association (LYSA) centers.
Thomas HuesoThomas GastinneSylvain GarciazEmmanuelle TchernonogCaroline DeletteRené-Olivier CasasnovasEric DurotRoch HouotBenoît TessoulinOlivier TournilhacSandra MalakEmmanuel GyanLuc-Matthieu ForneckerJulie AbrahamBaptiste DelapierreFrédéric PeyradeRichard LemalRémy GressinSylvain ChantepieCécile BorelRémy MorelloKrimo BouabdallahAhmad IbrahimReda BouabdallahSteven Le GouillGandhi DamajPublished in: Bone marrow transplantation (2020)
The combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) as conditioning regimen prior to autologous stem-cell transplantation (ASCT) remains the standard of care for patients with mantle cell lymphoma (MCL) who are eligible for transplantation. The replacement of carmustine with bendamustine (BeEAM) was described as a promising alternative in non-Hodgkin lymphoma. The aim of this retrospective study was to compare the BeEAM with the BEAM regimen in MCL patients in the frontline setting. Sixty and 108 patients were included in the BeEAM and the BEAM groups, respectively. At 3 years, progression-free survival (PFS) was significantly higher in the BeEAM than in the BEAM group (84% [73-96] vs. 63% [51-79], p = 0.03). The overall survival was not statistically different between the two groups (p = 0.2). In multivariable analysis, BeEAM regimen remained associated with higher PFS (HR = 0.377, 95% CI, 0.146-0.970; p = 0.043). Subgroup analyses in patients treated with prior rituximab-aracytine induction alone showed that BeEAM improved the PFS compared with BEAM regimen (p = 0.04). Despite the high rate of acute renal failure KDIGO III (32%), treatment-related mortality was not increased with the BeEAM regimen. A prospective randomized trial will be necessary to confirm the beneficial effect of the BeEAM regimen in MCL patients undergoing ASCT.
Keyphrases
- stem cell transplantation
- high dose
- end stage renal disease
- free survival
- patients undergoing
- newly diagnosed
- ejection fraction
- chronic kidney disease
- diffuse large b cell lymphoma
- healthcare
- prognostic factors
- bone marrow
- low dose
- monte carlo
- acute myeloid leukemia
- randomized controlled trial
- palliative care
- type diabetes
- chronic pain
- pain management
- intensive care unit
- stem cells
- coronary artery disease
- quality improvement
- combination therapy
- drug induced
- cardiovascular events
- hodgkin lymphoma
- mesenchymal stem cells