BEAM Autografting in Lymphoma—Experience at One Centre

Smith, A. G.; Long, S. G.; Janmohammed, R.; Macdonald, Dorothy F.; Leyland, M. J.; Milligan, Donald

doi:10.3109/10428199209061560

Cited by 4 publications

(1 citation statement)

References 13 publications

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“…8,[31][32][33][34] These results are comparable to TBI-based regimens, 8,20 TLI-based regimens 35,36 and to those using BEAM (BCNU, etoposide, ara-C, and melphalan). [37][38][39][40][41] Schedules of the CBV regimen employing a higher dose of infusional etoposide have been used in combination with maximum tolerated doses of cyclophosphamide and BCNU 24,26 in an attempt to overcome multidrug resistance and decrease mucositis severity. However, RRT has limited these efforts to a large extent as large cumulative doses and prolonged administration of BCNU is associated with increased pulmonary toxicity.…”

Section: Discussionmentioning

confidence: 99%

Intensive conditioning regimen of etoposide (VP-16), cyclophosphamide and carmustine (VCB) followed by autologous hematopoietic stem cell transplantation for relapsed and refractory Hodgkin's lymphoma

Benekli

Smiley

Younis

et al. 2007

Bone Marrow Transplant

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Several high-dose therapy regimens are used for autologous hematopoietic stem cell transplantation (auto-HSCT) for relapsed and refractory Hodgkin's lymphoma (HL) with variable disease response. An intensified regimen of etoposide (VP-16) 2400 mg/m 2 , cyclophosphamide 7200 mg/m 2 and carmustine (BCNU) 600 mg/ m 2 (VCB) pre-auto-HSCT was developed to overcome disease recurrence. A total of 43 relapsed and refractory HL patients underwent auto-HSCT between January 1992 and December 2004. At day 100 there were 37 (86%) complete responses. A total of 40 patients survived beyond day 100, 14 of whom subsequently relapsed/ progressed. At a median follow-up of 4.9 years (range 1.5-11.4 years), 26 patients (60%) are alive and disease free. Five-year actuarial event-free survival (EFS) was 53% (95% CI 35-70%) and median EFS was 5.9 years. Median progression-free and overall survivals have not been reached. EFS was reduced with an increasing number of prognostic factors (Karnofsky performance status, KPS o90, chemotherapy-resistant disease and X3 chemotherapy regimens prior to transplant p1 vs X2; P ¼ 0.049). Grade III-IV regimen-related toxicity was 9% (n ¼ 4). The 1-year cumulative incidence of interstitial pneumonitis (IP) was 36%, however only two patients died of IP complications. Disease progression was the most common cause of death (n ¼ 10, 23%). Intensive VCB is an effective and well-tolerated preparative regimen for relapsed and refractory HL auto-HSCT.

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Section: Discussionmentioning

confidence: 99%

Intensive conditioning regimen of etoposide (VP-16), cyclophosphamide and carmustine (VCB) followed by autologous hematopoietic stem cell transplantation for relapsed and refractory Hodgkin's lymphoma

Benekli

Smiley

Younis

et al. 2007

Bone Marrow Transplant

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Efficacy and toxicity of a CCNU-containing high-dose chemotherapy regimen followed by autologous hematopoietic cell transplantation in relapsed or refractory Hodgkin's disease

Stuart¹,

Chao²,

Horning³

et al. 2001

Biology of Blood and Marrow Transplantation

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High-dose CBV (cyclophosphamide, carmustine, and etoposide) in combination with autologous HCT achieves survival rates of approximately 50% at 5 years in recurrent or refractory Hodgkin's disease (HD). However, carmustine (BCNU) dose-dependent pulmonary toxicity occurs in 20% to 30% of patients. A decreased incidence of interstitial pneumonitis as well as a possible benefit in efficacy has been reported with lomustine (CCNU) compared to BCNU in the standard dose setting. In a dose-escalation study, we substituted CCNU for BCNU in the CBV regimen for 16 patients with HD (n = 12) or non-Hodgkin's lymphoma (n = 4). Based on the promising results, an additional 47 consecutive patients with HD were treated with the following regimen: CCNU (15 mg/kg) orally on day -6, etoposide (60 mg/kg) intravenously on day -4, and cyclophosphamide (100 mg/kg) intravenously on day -2. Peripheral blood progenitor cells and/or bone marrow were infused on day 0. With a median follow-up for the surviving patients of 3.2 years (range, 0.8-9.9 years), the 3-year overall survival rate was 57% (CI, +/-15%), event-free survival was 52% (CI, +/-14%), and freedom from progression was 68% (CI, +/-14%). There were 21 deaths, 10 due to HD. Six patients died due to respiratory failure. Interstitial pneumonitis occurred in 63% of patients and could not be correlated with prior chest radiotherapy. This regimen demonstrated survival rates similar to those of historical studies that used the CBV regimen. However, the incidence of interstitial pneumonitis was in excess of expected.

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The role of autografting in lymphoma

Milligan

Long

1994

Postgraduate Medical Journal

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BEAM Autografting in Lymphoma—Experience at One Centre

Cited by 4 publications

References 13 publications

Intensive conditioning regimen of etoposide (VP-16), cyclophosphamide and carmustine (VCB) followed by autologous hematopoietic stem cell transplantation for relapsed and refractory Hodgkin's lymphoma

Intensive conditioning regimen of etoposide (VP-16), cyclophosphamide and carmustine (VCB) followed by autologous hematopoietic stem cell transplantation for relapsed and refractory Hodgkin's lymphoma

Efficacy and toxicity of a CCNU-containing high-dose chemotherapy regimen followed by autologous hematopoietic cell transplantation in relapsed or refractory Hodgkin's disease

The role of autografting in lymphoma

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