BEAM conditioning regimen ensures better progression-free survival compared with TEAM but not with FEAM in lymphoma patients undergoing autologous stem cell transplant

Marchesi, Francesco; Capria, Saveria; Pedata, Mariangela; Terrenato, Irene; Ballotta, Laura; Riccardi, Cira; Papa, Elena; Riemma, Costantino; Trisolini, Silvia Maria; Celentano, Maria; Regazzo, Giulia; Ferrara, Felicetto; Mengarelli, Andrea; Picardi, Alessandra

doi:10.1080/10428194.2020.1765238

Cited by 6 publications

(2 citation statements)

References 10 publications

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“…[37][38][39] BCNU replaced by thiotepa as part of TEAM conditioning regimen has promising activity. [20][21][22] However, an observational study described the BEAM protocol to be superior in terms of clinical outcomes, 40 whereas a recent study shows similar results between BEAM and TEAM. 41 We hypothesize that organ dysfunction might play a crucial role in the outcomes of patients undergoing auto-HSCT and only selected patients might profit from TEAM conditioning before auto-HSCT.…”

Section: Discussionmentioning

confidence: 99%

Identification of clinical factors impacting outcome in patients undergoing autologous hematopoietic cell transplantation after BEAM and TEAM conditioning

Gherman,

Ewald,

Ihorst

et al. 2023

European J of Haematology

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Organ dysfunction, including pulmonary function impairment, plays a key role in the choice of conditioning chemotherapy before autologous hematopoietic stem cell transplantation (auto‐HSCT). Replacement of BCNU/carmustine as part of BEAM (BCNU/carmustine, etoposide, cytarabine, and melphalan) conditioning protocol by thiotepa (TEAM) reduces pulmonary toxicity while maintaining efficacy. We retrospectively analyzed the association of clinical characteristics, comorbidities, and organ function with outcomes after conditioning with BEAM or TEAM. Three hundred ninety‐six patients undergoing auto‐HSCT (n = 333 with BEAM; n = 63 with TEAM) at our institution between 2008 and 2021 were included in this study. In the multivariate analysis, CO‐diffusion capacity corrected for hemoglobin (DLCOcSB) ≤ 60% of predicted, progressive disease (PD) before auto‐HSCT, Karnofsky performance score (KPS) ≤ 80%, HCT‐CI score ≥ 4, and cardiac disease before auto‐HSCT were associated with decreased overall survival (OS) in patients treated with BEAM. In contrast, only PD before auto‐HSCT was identified in patients treated with TEAM. Patients conditioned with BEAM and DLCOcSB ≤ 60% had higher non‐relapse mortality, including pulmonary cause of death. In summary, we have identified clinical and pulmonary risk factors associated with worse outcomes in patients conditioned with BEAM compared to TEAM. Our data suggest TEAM conditioning as a valid alternative for patients with comorbidities, including pulmonary dysfunction and/or poorer performance scores, before auto‐HSCT.

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Section: Discussionmentioning

confidence: 99%

Identification of clinical factors impacting outcome in patients undergoing autologous hematopoietic cell transplantation after BEAM and TEAM conditioning

Gherman,

Ewald,

Ihorst

et al. 2023

European J of Haematology

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“…One of the most commonly used HDT regimen is the BEAM (BCNU/carmustine, etoposide, cytarabine, and melphalan) protocol [6][7][8]. However, BCNU/carmustine is associated with a number of toxicities, e.g., pulmonary side effects.…”

Section: Introductionmentioning

confidence: 99%

Treosulfan plus fludarabine versus TEAM as conditioning treatment before autologous stem cell transplantation for B-cell Non-Hodgkin lymphoma

Frietsch

Miethke

Linke

et al. 2022

Bone Marrow Transplant

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Conditioning with treosulfan and fludarabine (Treo/Flu) has been proven to be feasible and efficient in several types of malignancies before allogeneic hematopoietic stem cell transplantation (allo-HSCT). Given its favorable reduced toxicity profile, we introduced Treo/Flu as conditioning before autologous HSCT (auto-HSCT) in patients with B-cell Non-Hodgkin lymphoma (NHL). The aim of this study was to evaluate the efficacy and safety of Treo/Flu in comparison to TEAM. Fifty-seven patients with NHL received auto-HSCT after conditioning with either Treo/Flu (n = 22) or TEAM (n = 35). All patients achieved sustained engraftment. PFS, EFS and OS were not significant in both groups. Of note is that patients in the Treo/Flu group were less dependent on thrombocyte transfusions (p = 0.0082), significantly older (in median 11 years, p < 0.0001) and suffered less frequently from infectious complications (p = 0.0105), mucositis and stomatitis (p < 0.0001). This study is the first to present efficacy, feasibility, and safety of conditioning with Treo/Flu preceding auto-HSCT in patients with NHL. Since it demonstrated a lack of significant difference in comparison to TEAM conditioning it might be a valuable alternative especially in elderly patients with B-cell NHL and comorbidities. Further evaluation by prospective clinical trials is warranted.

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Long-Term Results with Thiotepa-Containing Conditioning Regimens for Autologous Stem Cell Transplantation

Cohen

Lebel

Zimran

et al. 2023

Transplantation and Cellular Therapy

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BEAM conditioning regimen ensures better progression-free survival compared with TEAM but not with FEAM in lymphoma patients undergoing autologous stem cell transplant

Cited by 6 publications

References 10 publications

Identification of clinical factors impacting outcome in patients undergoing autologous hematopoietic cell transplantation after BEAM and TEAM conditioning

Identification of clinical factors impacting outcome in patients undergoing autologous hematopoietic cell transplantation after BEAM and TEAM conditioning

Treosulfan plus fludarabine versus TEAM as conditioning treatment before autologous stem cell transplantation for B-cell Non-Hodgkin lymphoma

Long-Term Results with Thiotepa-Containing Conditioning Regimens for Autologous Stem Cell Transplantation

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