title: Busulfan-containing conditioning regimens are optimal preparative regimens for autologous stem cell transplant in patients with diffuse large B-cell lymphoma.
abstract: We retrospectively examined the outcomes of 56 patients with diffuse large B-cell lymphoma (DLBCL) who underwent autologous stem cell transplant (ASCT) with BEAM/BEAC (carmustine, etoposide, cytarabine, melphalan/cyclophosphamide) or busulfan (Bu)-containing conditioning regimens. The Bu group had lower disease-related mortality and more frequent achievement of complete remission (CR) after ASCT from partial remission (PR) or refractory status before ASCT compared with the BEAM/BEAC group. The estimated 2-year EFS (59.3% vs. 15.0%) and overall survival (OS) (70.2% vs. 42.0%) in pre-ASCT rituximab-exposed patients with DLBCL were higher in the Bu group. In patients with high-risk DLBCL exposed to rituximab with first remission, the Bu group had better EFS (p = 0.004) and OS (p = 0.053) rates, while survival rates for relapsed/refractory patients did not differ between groups. Bu regimens are highly effective for preparing patients with DLBCL with previous exposure to rituximab for ASCT, especially in high-risk patients who achieved a first remission.
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Medical Research Institute, Pusan National University Hospital , Busan , Korea.
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Won-Sik
authors.initials: WS
authors.lastname: Lee
authors.forename: Ho-Seop
authors.initials: HS
authors.lastname: Lee
authors.forename: Hawk
authors.initials: H
authors.lastname: Kim
authors.forename: Gyeong-Won
authors.initials: GW
authors.lastname: Lee
authors.forename: Moo-Kon
authors.initials: MK
authors.lastname: Song
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Kim
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Yhim
authors.forename: Joo Seop
authors.initials: JS
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002066:Busulfan / Q000008:administration & dosage / Q000627:therapeutic use*; D002330:Carmustine / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000628:therapy*; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000379:methods*; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D003561:Cytarabine; D005047:Etoposide; D003520:Cyclophosphamide; D002066:Busulfan; D008558:Melphalan; D002330:Carmustine
keywords: BEAM regimen; Busulfan; diffuse; hematopoietic stem cell transplant; large B-cell; lymphoma