Comparison of Efficacy and Safety of BEAC BEAM and Be-EAM Conditioning Regimens Prior to Autologous Stem Cell Transplantation in Lymphoma

Abstract

Autologous hematopoietic stem cell transplantation is recommended and significantly improved the prognosis of lymphoma patients. However, the preferred conditioning regimen prior to autologous hematopoietic stem cell transplantation is still a controversial topic. Current experiment was aim to explore the efficacy and safety of BEAC (carmustine, etoposide, cytarabine and cyclophosphamide), BEAM (carmustine, etoposide, cytarabine and melphalan) and Be-EAM (bendamustine, cytarabine, etoposide and melphalan) preparative regimens in lymphoma patients who underwent autologous hematopoietic stem cell transplantation. 19 lymphoma cases were enrolled and followed-up for 13 mo, 6 cases were treated with BEAC, 5 cases were treated with BEAM and 8 cases were treated with Be-EAM. We found the median progression free survival was 23 mo in BEAC group, but the progression free survival and the overall survival in the other 2 groups had not been reached due to the short follow-up time. The median of patients achieved neutrophil and platelet engraftment were 12.500 and 15.167 d in BEAC group, 11.200 and 14.000 d in BEAM group and Be-EAM cohort were 11.250 and 11.750 d. Statistically differences on platelet engraftment were observed in Be-EAM comparing with BEAC and BEAM regimens. Additionally, the volume of platelet transfusion in the Be-EAM group was the least in three groups. The main adverse events included bone marrow suppression, fever, mucositis, nausea and vomiting and all of them were acceptable. The efficacy and safety were favorable in lymphoma patients who received conditioning treatment with Be-EAM comparing with BEAC and BEAM regimens. The Be-EAM regimen has a shorter hospital stay, faster hematopoietic reconstitution, fewer platelet infusions and the superiority of storage conditions and drug cost of bendamustine, the Be-EAM regimen could be a potential optimistic option for lymphoma conditioning treatment.