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ISSN: 1428-2526
Contemporary Oncology/Współczesna Onkologia
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2/2024
vol. 28
 
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abstract:
Original paper

Evaluation of outcome and safety profile in high-dose BEAM and Benda-EAM chemotherapy with subsequent autologous stem cell transplantation in lymphoma patients

Kinga Krawiec
1
,
Piotr Strzałka
1
,
Olga Racińska
2
,
Marcin Kędzior
2
,
Hubert Sowul
2
,
Wojciech Salamon
2
,
Kacper Kościelny
2
,
Michał Kośny
1
,
Damian Mikulski
3
,
Agnieszka Pluta
1
,
Agnieszka Wierzbowska
1

  1. Department of Hematology, Medical University of Łódź, Łódź, Poland
  2. Medical University of Łódź, Łódź, Poland
  3. Department of Biostatistics and Translational Medicine, Medical University of Łódź, Łódź, Poland
Contemp Oncol (Pozn) 2024; 28 (2): 158–166
DOI: https://doi.org/10.5114/wo.2024.141794
Online publish date: 2024/07/26
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Introduction:
Autologous hematopoietic stem cell transplantation (auto- HSCT) preceded by high-dose chemotherapy is a mainstay in relapsed/refractory lymphoma. The study aimed to compare the efficacy and adverse event profile between BEAM and Benda-EAM (BeEAM) regimens and to evaluate prognostic factors for survival in lymphoma patients undergoing auto-HSCT.

Material and methods:
We present a single-center retrospective analysis of 82 lymphoma patients (median age 52; IQR 38.2–62.2) who received BEAM (47.6%) or BeEAM (52.4%) followed by auto-HSCT between January 2015 and December 2021.

Results:
During the post-HSCT period 58% of patients experienced febrile neutropenia (51.3% vs. 64.3% in BEAM and BeEAM, respectively; p = 0.27), 80.5% mucositis (69.2% vs. 90.7%; p = 0.02), 42.5% bacteremia (50% vs. 35.7%; p = 0.26), and 18.8% pneumonia (31.6% vs. 7.1%; p = 0.01). Patients who received bendamustine required more platelet transfusions (p = 0.02). In the multivariate Cox regression model, C-reactive protein level on the first day of hospitalization (hazard ratio – HR = 1.03, 95% CI: 1.01–1.06) and days of agranulocytosis (HR = 1.15, 95% CI: 1.00–1.32) were predictors of poorer overall survival (OS), whereas hemoglobin level at the auto-HSCT was a protective factor in terms of OS (HR = 0.43, 95% CI: 0.23–0.78) and progression-free survival (PFS) (HR = 0.66, 95% CI: 0.45–0.96). The median OS since auto-HSCT was 87 months, while the median PFS was 49 months. No differences in PFS and OS between BEAM and BeEAM regimens were proven.

Conclusions:
Conditioning with BEAM and BeEAM regimens is associated with comparable post-transplant outcomes. The toxicity of these regimens is comparable; however, BEAM is associated with a higher risk of pneumonia, while BeEAM is associated with a higher risk of mucositis.

keywords:

lymphoma, BEAM, auto- HSCT, BeEAM
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