HL-401: Long-Term Follow-Up of Patients with Non-Hodgkin and Hodgkin Lymphomas with a Modified BEAM Conditioning Regimen

Abstract

Auto BMT has been performed in Non-Hodgkin Lymphomas (NHL) and Hodgkin Lymphoma (HL) patients with a poor prognosis using a modified BEAM conditioning regimen in a tertiary referral center in Mexico City. A retrospective analysis of patients with the diagnosis of T-cell NHL (anaplastic T-cell NHL, cytotoxic T-cell NHL, centrofacial T-cell NHL, angioimmunoblastic T-cell NHL, NOS T-cell NHL), and MCL in first complete remission and diffuse large B cell NHL in chemosensitive relapse, as well as HL patients (nodular sclerosis, mixed cellularity, lymphocyte depleted, and non-specified disease) in chemosensitive relapse underwent autologous transplantation between January 1990 and December 2018. G-CSF at 10 mcg/kg/day 5–6 days and cell collection was conducted on an ambulatory basis. We avoided using cryopreservation of blood products in order to reduce costs. Patients were conditioned with high-dose BEAM chemotherapy (Carmustine BCNU IV, 300 mg/m2 infused over 3 hours on day 3, Cytosine Arabinoside IV, 1000 mg/m2 in two doses on day 2, Etoposide IV, 800 mg/m2 in three doses on days 2 and 3 and Melphalan PO, 140 mg/m2 on day 1). Prophylactic antibiotics were administered. Thirty nine (61%) patients were transplanted: 42 had NHL and 19 had HL. The patients' age ranged between 17 and 64 years at diagnosis (median: 31 years); 17 were female (34.5%), and 40 were male (65.5%). The estimated 5-year survival was 65% (91% in HL and 78% in NHL) and disease-free survival 51%, values similar to other published series. T-cell lymphomas were analyzed separately, yielding a DFS and OS of 73% for both. Patients with a negative PET scan after transplant had a greater OS than those with a positive scan (74% vs. 35%, respectively); this difference was statistically significant (log rank=0.0001). These results are higher than those reported by other groups. In summary, patients with high-risk lymphoma can be salvaged with HSCT with a modified conditioning regimen that minimizes cost and time in developing countries.