Single-center retrospective study assessing the efficacy and safety of BeEAM (bendamustine, etoposide, cytarabine, melphalan) as conditioning regimen for autologous hematopoietic stem cell transplantation

Leuk Lymphoma. 2023 Jul-Aug;64(7):1234-1242. doi: 10.1080/10428194.2023.2203790. Epub 2023 May 8.

Abstract

One of the most widely accepted conditioning regimens for hematopoietic stem cell transplantation (HSCT) is BEAM (carmustine, etoposide, cytarabine, melphalan). However, a recent increase in the cost of carmustine has limited its use bringing our institution to replace carmustine with bendamustine. This observational retrospective single-center study aims to report the efficacy and safety of the BeEAM regimen. 55 patients with diffuse large B-cell lymphoma (47%), Hodgkin lymphoma (25%), mantle cell lymphoma (25%), or follicular lymphoma (2%) were included. Progression-free survival (PFS) at 24 months was 75% and overall survival (OS) was 83%. Treatment-related mortality was 4%. The most common adverse effects were febrile neutropenia (98%), mucositis (72%) and colitis (60%). Our study demonstrated excellent efficacy of the BeEAM regimen. However, the toxicity profile of BeEAM significantly varies from one study to another, and guidelines suggesting optimal dose of bendamustine and supportive care are currently lacking.

Keywords: Hodgkin lymphoma; autologous hematopoietic stem cell transplantation; bendamustine; non-Hodgkin lymphoma.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Bendamustine Hydrochloride / adverse effects
  • Carmustine / adverse effects
  • Cytarabine / adverse effects
  • Etoposide / adverse effects
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Lymphoma, Non-Hodgkin* / pathology
  • Melphalan / adverse effects
  • Neoplasm Recurrence, Local / etiology
  • Retrospective Studies
  • Transplantation, Autologous

Substances

  • Bendamustine Hydrochloride
  • Melphalan
  • Carmustine
  • Etoposide
  • Cytarabine