Carmustine, etoposide, cytarabine and melphalan as a preparative regimen for allogeneic transplantation for high-risk malignant lymphoma

D. Przepiorka, K. Van Besien, I. Khouri, F. Hagemeister, B. Samuels, J. Folloder, N. T. Ueno, J. Molldrem, R. Mehra, M. Körbling, S. Giralt, J. Gajewski, M. Donato, K. Cleary, D. Claxton, I. Braunschweig, B. Andersson, P. Anderlini, R. Champlin

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

Background: The combination of carmustine, etoposide, cytarabine and melphalan (BEAM) is an effective autologous transplantation preparative regimen for lymphoma and has little toxicity, but the feasibility and tolerance of BEAM as a preparative regimen for allogeneic transplantation has not been established. Patients and methods: Thirty adults with primary refractory or recurrent intermediate- or low-grade lymphoma were treated on a prospective phase II study with carmustine 300 mg/m2 i.v. day -6, etoposide 200 mg/m2 i.v, followed by cytarabine 200 mg/m2 i.v. twice daily days -5 to -2, melphalan 140 mg/m2 i.v. day -1, and marrow or blood stem cells from an HLA-identical donor on day 0. Tacrolimus and methotrexate were used to prevent graft-vs.-host disease (GVHD). Results: Median time from transplantation was 20 mos (range 6 - 32 months). Median maximal regimen- related toxicity grade was 2, and four patients (13%) had a grade 3-4 regimen-related toxicity. Two patients had idiopathic interstitial pneumonitis. One patient had primary graft failure, and a second had autologous reconstitution documented at three months posttransplant. Grades 2-4 acute GVHD occurred in 31%, grades 3-4 in 16%, and chronic GVHD in 54%. Day-100 survival was 70%. Twenty-three patients achieved a complete response. The two-year relapse rate was 23%, survival was 48%, and disease-free survival (DFS) was 42%. Conclusions: BEAM supports engraftment of allogeneic transplants and is a tolerable preparative regimen for allogeneic transplantation for lymphoma.

Original languageEnglish (US)
Pages (from-to)527-532
Number of pages6
JournalAnnals of Oncology
Volume10
Issue number5
DOIs
StatePublished - Jan 1 1999

Keywords

  • Allogeneic transplantation
  • BEAM
  • Lymphoma

ASJC Scopus subject areas

  • Hematology
  • Oncology

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    Przepiorka, D., Van Besien, K., Khouri, I., Hagemeister, F., Samuels, B., Folloder, J., Ueno, N. T., Molldrem, J., Mehra, R., Körbling, M., Giralt, S., Gajewski, J., Donato, M., Cleary, K., Claxton, D., Braunschweig, I., Andersson, B., Anderlini, P., & Champlin, R. (1999). Carmustine, etoposide, cytarabine and melphalan as a preparative regimen for allogeneic transplantation for high-risk malignant lymphoma. Annals of Oncology, 10(5), 527-532. https://doi.org/10.1093/oxfordjournals.annonc.a010369