A retrospective, matched paired analysis comparing bendamustine containing BeEAM versus BEAM conditioning regimen: results from a single center experience

Abstract

The combination of carmustine, etoposide, aracytin, and melphalan(BEAM) conditioning regimen in autologous stem-cell transplantation (ASCT) is widely used in patients with relapsed/refractory non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma. It is also an option in patients with very-high risk aggressive NHL in first complete remission (CR). Recently, a phase Ib-II feasibility study using bendamustine replacing carmustine (BCNU) was reported. We report herein a safety and efficacy analysis of bendamustine-EAM (BeEAM) with a control BEAM counterpart paired cohort (1/2). One hundred and two patients were analyzed. Overall survival (OS) and progression-free survival (PFS) were not reached and seemed to be comparable between both groups. However, grade III or greater diarrhea was significantly higher in BeEAM patients (44 vs. 15%, p = .002). The median number of days with fever >38 °C was significantly higher in BeEAM group (5.5 vs. 2, p < .001). This case-control study suggests that BeEAM followed by ASCT using bendamustine at 100 mg/m/d is effective but has a different toxicity profile than the BEAM regimen.

High‐dose Bendamustine‐EAM followed by autologous stem cell rescue results in long‐term remission rates in lymphoma patients, without renal toxicity

“…It must be mentioned here that we are following a generous hydration policy during conditioning chemotherapy, with 2‐3 L fluid administration daily. In contrast to other comparable studies, no grade II‐IV nephrotoxicity was observed.…”

“…Remarkably in this investigation, a significant lower dose of bendamustine was studied (100 mg/m 2 on two consecutive days). 22 Resuming published and our own data, BendaEAM conditioning with following autologous stem cell transplantation leads to longterm remission rates of 55%-65% in HD, MCL, and DLBCL, and of approximately 30%-35% in aggressive T-cell lymphoma and FL.…”

“…A French single‐center analysis showed more serious adverse events, mainly gastrointestinal toxicity with significantly more weight loss and longer hospitalization in patients receiving bendamustine‐containing conditioning before transplantation. Remarkably in this investigation, a significant lower dose of bendamustine was studied (100 mg/m 2 on two consecutive days) …”

Bendamustine-EAM versus BEAM regimen in patients with mantle cell lymphoma undergoing autologous stem cell transplantation in the frontline setting: a multicenter retrospective study from Lymphoma Study Association (LYSA) centers

“…20,28 Furthermore, 47% of patients presented with grade III-IV mucositis, which is more frequent than in previous studies on the BEAM regimen. 29,30,31,18 Gastro intestinal toxicity could explain the high rate of septicemia with bacteria from digestive tract but as renal toxicity, it remained manageable and was not associated with increased NRM in our study.…”

Immunomodulatory Effects of Bendamustine in Hematopoietic Cell Transplantation

“…It has been used as an effective lymphodepleting agent prior to infusion of chimeric antigen receptor (CAR) T-cells [13]. BEN has also been employed as a component of conditioning regimens for autologous hematopoietic cell transplantation (HCT) to treat multiple myeloma, Hodgkin's lymphoma, mantle cell lymphoma, and other non-Hodgkin's lymphomas [10,[14][15][16][17]. More recently, BEN has been implemented in the context of clinical allogeneic HCT and has been studied in murine HCT models, both highlighting its immunomodulatory effects and suggesting favorable immunomodulation resulting in graft-versus-host disease (GvHD) and tumor control.…”