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, Ira Braunschweig, B. Andersson, P. Anderlini, R. Champlin

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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
StatePublished - 1999
Externally publishedYes

Fingerprint

Carmustine
Melphalan
Cytarabine
Homologous Transplantation
Etoposide
Lymphoma
Transplants
Survival
Autologous Transplantation
Interstitial Lung Diseases
Tacrolimus
Methotrexate
Non-Hodgkin's Lymphoma
Disease-Free Survival
Blood Cells
Stem Cells
Transplantation
Bone Marrow
Tissue Donors
Recurrence

Keywords

  • Allogeneic transplantation
  • BEAM
  • Lymphoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Hematology

Cite this

Przepiorka, D., Van Besien, K., Khouri, I., Hagemeister, F., Samuels, B., Folloder, J., ... 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.

Carmustine, etoposide, cytarabine and melphalan as a preparative regimen for allogeneic transplantation for high-risk malignant lymphoma. / 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, Ira; Andersson, B.; Anderlini, P.; Champlin, R.

In: Annals of Oncology, Vol. 10, No. 5, 1999, p. 527-532.

Research output: Contribution to journalArticle

Przepiorka, D, Van Besien, K, Khouri, I, Hagemeister, F, Samuels, B, Folloder, J, Ueno, NT, 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, vol. 10, no. 5, pp. 527-532.
Przepiorka D, Van Besien K, Khouri I, Hagemeister F, Samuels B, Folloder J et al. Carmustine, etoposide, cytarabine and melphalan as a preparative regimen for allogeneic transplantation for high-risk malignant lymphoma. Annals of Oncology. 1999;10(5):527-532.
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, Ira ; Andersson, B. ; Anderlini, P. ; Champlin, R. / Carmustine, etoposide, cytarabine and melphalan as a preparative regimen for allogeneic transplantation for high-risk malignant lymphoma. In: Annals of Oncology. 1999 ; Vol. 10, No. 5. pp. 527-532.
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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.",
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T1 - Carmustine, etoposide, cytarabine and melphalan as a preparative regimen for allogeneic transplantation for high-risk malignant lymphoma

AU - Przepiorka, D.

AU - Van Besien, K.

AU - Khouri, I.

AU - Hagemeister, F.

AU - Samuels, B.

AU - Folloder, J.

AU - Ueno, N. T.

AU - Molldrem, J.

AU - Mehra, R.

AU - Körbling, M.

AU - Giralt, S.

AU - Gajewski, J.

AU - Donato, M.

AU - Cleary, K.

AU - Claxton, D.

AU - Braunschweig, Ira

AU - Andersson, B.

AU - Anderlini, P.

AU - Champlin, R.

PY - 1999

Y1 - 1999

N2 - 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.

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KW - Allogeneic transplantation

KW - BEAM

KW - Lymphoma

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