title: Results of autologous transplantation in lymphoma are not improved by increasing the dose of etoposide in the BEAM regimen: a single-centre sequential-cohort study.
abstract: We have undertaken a retrospective sequential-cohort analysis of 131 lymphoma patients treated with the BEAM regimen and autologous stem cell transplantation, to compare BEAM at standard doses (sBEAM; n = 67 from May 1990 to April 1995) and BEAM with escalated etoposide dose from 800 to 1600 mg/m(2) (eBEAM; n = 64 from May 1995 to June 1999). Transplant-related mortality and incidence of secondary malignancies were similar in both groups. Disease progression was significantly lower in indolent lymphoma (IL) patients receiving eBEAM (7 vs 43%), although survival was comparable due to a higher toxic mortality in the eBEAM group. The 5-year event-free survival and overall survival were better in Hodgkin's disease (HD) patients treated with eBEAM (70 and 77%, respectively) compared to sBEAM (58 and 69%, respectively), but the difference was not statistically significant. In aggressive lymphomas, no difference was detected between groups. Our results indicate that while escalation of the etoposide doses in the BEAM conditioning regimen does not appear to improve outcome, encouraging results in IL and HD may warrant further studies.
authors.affiliation: Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Paseo de San Vicente 58-182, Salamanca, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Martín
authors.forename: M D
authors.initials: MD
authors.lastname: Caballero
authors.forename: J A
authors.initials: JA
authors.lastname: Pérez-Simón
authors.forename: N
authors.initials: N
authors.lastname: López-Holgado
authors.forename: M V
authors.initials: MV
authors.lastname: Mateos
authors.forename: M C
authors.initials: MC
authors.lastname: Cañizo
authors.forename: J F San
authors.initials: JF
authors.lastname: Miguel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002330:Carmustine / Q000627:therapeutic use*; D015331:Cohort Studies; D003561:Cytarabine / Q000627:therapeutic use*; D018450:Disease Progression; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005047:Etoposide / Q000008:administration & dosage* / Q000627:therapeutic use*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy* / Q000628:therapy*; D008297:Male; D008558:Melphalan / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous
chemical_list: D003561:Cytarabine; D005047:Etoposide; D008558:Melphalan; D002330:Carmustine