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A Retrospective Comparison of Mitoxantrone-Melphalan and BEAM Conditioning Regimens Before Autologous Hematopoietic Stem Cell Transplantation in Relapsed/Refractory Lymphoma Patients

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Abstract

High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (AHSCT) is considered the standard therapy for patients with relapsed lymphoma. The aim of our study is the comparison of mitoxantrone-melphalan and BEAM (carmustine, etoposide, cytarabin and melphalan) conditioning regimens before autologous hematopoietic stem cell transplant in patients with lymphoma. This study has been performed in a retrospective manner. Hundred and two patients with relapsed/refractory Hodgkin lymphoma (n = 35) and non-Hodgkin lymphoma (n = 67) who underwent high-dose treatment followed by AHSCT at Memorial Sisli Hospital between 2013 and 2018 were evaluated. We retrieved data on patient demographics, disease status and post AHSCT outcomes. For conditioning regimen 52 patients received mitoxantrone (60 mg/m2 × 1 day) and melphalan (180 mg/m2 × 1 day) and 50 patients received BEAM (carmustine at 300 mg/m2 × 1 day, etoposide at 200 mg/m2 × 4 days, cytarabine at 2 × 200 mg/m2 × 4 days and melphalan at 140 mg/m2 × 1 day). The median age was 45 (18–73) years at the time of the diagnosis. No significant difference was observed in baseline characteristics between groups, including the disease control and previous therapies. Prior to high-dose chemotherapy, 79.4% of the patients were in complete remission (CR) and 20.6% was in partial remission (PR). With a median follow up of 30.5 months (range: 1–70 months) for the whole cohort, even though the OS was similar in both groups (86% ± 2.4 vs. 84% ± 3.2; p = 0.85), the PFS was noted to be superior among those who received conditioning with BEAM protocol (55% ± 3.7) compared to those with mitoxantrone-melphalan (30.6% ± 2.8; p = 0.006). In conclusion, we demonstrated that the BEAM regimen is an effective high-dose chemotherapy for lymphoma patients before AHSCT. Nevertheless mitoxantrone-melphalan regimen is also an alternative to the BEAM regimen.

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References

  1. Moskowitz AJ, Moskowitz CH (2009) Controversies in the treatment of lymphoma with autologous transplantation. Oncologist 14:921–929. https://doi.org/10.1634/theoncologist.2009-0162

    Article  CAS  PubMed  Google Scholar 

  2. Sirohi B, Cunningham D, Powles R et al (2008) Long-term outcome of autologous stem-cell transplantation in relapsed or refractory Hodgkin’s lymphoma. Ann Oncol 19:1312–1319. https://doi.org/10.1093/annonc/mdn052

    Article  CAS  PubMed  Google Scholar 

  3. Linch DC, Winfield D, Goldstone AH et al (1993) Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin’s disease: results of a BNLI randomised trial. Lancet 341:1051–1054. https://doi.org/10.1016/0140-6736(93)92411-l

    Article  CAS  PubMed  Google Scholar 

  4. Isidori A, Christofides A, Visani G (2016) Novel regimens prior to autologous stem cell transplantation for the management of adults with relapsed/refractory non-Hodgkin lymphoma and Hodgkin lymphoma: alternatives to BEAM conditioning. Leuk Lymphoma 57(11:2499–2509. https://doi.org/10.1080/10428194.2016.1185785

    Article  CAS  PubMed  Google Scholar 

  5. Mills W, Chopra R, McMillan A et al (1995) BEAM chemotherapy and autologous bone marrow transplantation for patients with relapsed or refractory non-Hodgkin’s lymphoma. J Clin Oncol 13(3):588–595. https://doi.org/10.1200/jco.1995.13.3.588

    Article  CAS  PubMed  Google Scholar 

  6. Pasquini M, Wang Z, Horowitz M et al (2010) Report from the Center for International Blood and Marrow Transplant Research (CIBMTR): current uses and outcomes of hematopoietic cell transplants for blood and bone marrow disorders. Clin Transpl 2010:87–105

    Google Scholar 

  7. Ulrickson M, Aldridge J, Kim HT et al (2009) Busulfan and cyclophosphamide (Bu/Cy) as a preparative regimen for autologous stem cell transplantation in patients with non-Hodgkin lymphoma: a single-institution experience. Biol Blood Marrow Transpl 15:1447–1454. https://doi.org/10.1016/j.bbmt.2009.07.014

    Article  CAS  Google Scholar 

  8. Philip T, Guglielmi C, Hagenbeek A et al (1995) Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma. N Engl J Med 333:1540–1545. https://doi.org/10.1056/nejm199512073332305

    Article  CAS  PubMed  Google Scholar 

  9. Saleh K, Danu A, Koscielny S et al (2018) A retrospective, matched paired analysis comparing bendamustine containing BeEAM versus BEAM conditioning regimen: results from a single center experience. Leuk Lymphoma 59(11):2580–2587. https://doi.org/10.1080/10428194.2017.1403019

    Article  CAS  PubMed  Google Scholar 

  10. Musso M, Messina G, Renzo Di et al (2016) Improved outcome of patients with relapsed/refractory Hodgkin lymphoma with a new fotemustine-based high-dose chemotherapy regimen. Br J Haematol 172(1):111–121. https://doi.org/10.1111/bjh.13803

    Article  CAS  PubMed  Google Scholar 

  11. Joffe E, Rosenberg D, Rozovski U et al (2018) Replacing carmustine by thiotepa and cyclophosphamide for autologous stem cell transplantation in Hodgkin’s and non-Hodgkin’s B-cell lymphoma. Bone Marrow Transpl 53:29–33. https://doi.org/10.1038/bmt.2017.205

    Article  CAS  Google Scholar 

  12. Gupta A, Gokarn A, Rajamanickam D et al (2018) Lomustine, cytarabine, cyclophosphamide, etoposide: an effective conditioning regimen in autologous hematopoietic stem cell transplant for primary refractory or relapsed lymphoma: analysis of toxicity, long-term outcome, and prognostic factors. J Cancer Res Ther 14:926–933. https://doi.org/10.4103/0973-1482.181183

    Article  CAS  PubMed  Google Scholar 

  13. Kim JW, Lee HJ, Yi HG et al (2012) Mitoxantrone, etoposide, cytarabine, and melphalan (NEAM) followed by autologous stem cell transplantation for patients with chemosensitive aggressive non-Hodgkin lymphoma. Am J Hematol 87(5):479–483. https://doi.org/10.1002/ajh.23150

    Article  CAS  PubMed  Google Scholar 

  14. Salar A, Sierra J, Gandarillas M et al (2001) Autologous stem cell transplantation for clinically aggressive non-Hodgkin’s lymphoma: the role of preparative regimens. Bone Marrow Transpl 27:405–412. https://doi.org/10.1038/sj.bmt.1702795

    Article  CAS  Google Scholar 

  15. Okay M, Buyukasık Y, Demiroglu H et al (2019) Mitoxantrone-melphalan conditioning regimen for autologous stem cell transplantation in relapsed/refractory lymphoma. Turk J Med Sci 49:985–992. https://doi.org/10.3906/sag-1809-36

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Chen Y-B, Lane AA, Logan BR et al (2015) Impact of conditioning regimen on outcomes for patients with lymphoma undergoing high-dose therapy with autologous hematopoietic cell transplantation. Biol Blood Marrow Transpl 21(6):1046–1053. https://doi.org/10.1016/j.bbmt.2015.02.005

    Article  Google Scholar 

  17. Sellner L, Boumendil A, Finel H et al (2016) Thiotepa-based high-dose therapy for autologous stem cell transplantation in lymphoma: a retrospective study from the EBMT. Bone Marrow Transpl 51:212–218. https://doi.org/10.1038/bmt.2015.273

    Article  CAS  Google Scholar 

  18. Rosenberg D, Joffe E, Rozovski U et al (2015) Comparison of the low toxicity TECAM conditioning regimen to BEAM in patients with lymphoma requiring autologous stem cell transplantation. Blood 126(23):3188. https://doi.org/10.1182/blood.V126.23.3188.3188

    Article  Google Scholar 

  19. Giuseppe V, Malerba L, Stefani PM et al (2011) BeEAM (bendamustine, etoposide, cytarabine, melphalan) before autologous stem cell transplantation is safe and effective for resistant/relapsed lymphoma patients. Blood 118(12):3419–3425. https://doi.org/10.1182/blood-2011-04-351924

    Article  CAS  Google Scholar 

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  1. Department of Hematology, Faculty of Medicine, Medicalpark Gaziosmanpasa Hospital, Istinye University, Istanbul, Turkey

    Aysun Halacoglu & Songul Serefhanoglu

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  1. Aysun Halacoglu
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  2. Songul Serefhanoglu
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Correspondence to Aysun Halacoglu.

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Halacoglu, A., Serefhanoglu, S. A Retrospective Comparison of Mitoxantrone-Melphalan and BEAM Conditioning Regimens Before Autologous Hematopoietic Stem Cell Transplantation in Relapsed/Refractory Lymphoma Patients. Indian J Hematol Blood Transfus 38, 92–98 (2022). https://doi.org/10.1007/s12288-021-01439-4

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