Comparative Analysis of Conditioning Regimens in Patients Undergoing Autologous Hematopoietic STEM CELL Transplant for Lymphoma in a Single Brazilian Center

Abstract

Introduction The use of myeloablative conditioning regimen followed by autologous hematopoietic stem cell infusion is considered as standard of care for the first or second line treatment for diverse types of lymphoma. However, studies comparing different conditioning regimens are not frequent, and its choice can be based on transplant center's experience. In the last few years, our center had different choices due to the unavailability of some chemotherapy drugs, and the main options were BEAM, CBV and busulfan based regimen (BuMel). Objective Perform a comparative analysis among the three conditioning regimens used in our center, assessing the impact on toxicity and survival. Methods A retrospective cohort including lymphoma patients, who underwent first autologous transplant at our center from January 2014 to December 2017, were evaluated regarding toxicity - renal, hepatic, cardiovascular, gastrointestinal (including diarrhea) - as primary endpoint, doing paired analysis - according to the CTCAE (v 4.0). Results 120 patients were included – 46 patients used BEAM, 44 patients used CBV, and 30 patients used BuMel as conditioning regimen. Regarding patient's characteristics, there was no statistically difference in gender, type of lymphoma, and age. We observed distinct toxicity profiles between the groups. For renal toxicity, there was a difference between CBV (34.1%) and BEAM (11.1%), p=0.02. For hepatic toxicity, CBV (59.1%) was different than BuMel (16.7%), p=0.0008, and BEAM (13.0%), p Conclusion Our data did not show major differences in toxicities and other complications among the three conditioning groups. There was no impact on disease-free and overall survival. Therefore, all three options can be feasible as conditioning regimen for patients with lymphoma.