title: Carmustine, etoposide, cytarabine and melphalan versus a newly designed intravenous busulfan-based Busulfex, etoposide and melphalan conditioning regimen for autologous hematopoietic cell transplant: a retrospective matched-pair analysis in advanced Hodgkin and non-Hodgkin lymphomas.
abstract: Optimal conditioning remains a challenge in lymphomas. We designed a regimen consisting of Busulfex, etoposide and melphalan (BuEM). We retrospectively analyzed the outcome of patients conditioned with carmustine, etoposide, cytarabine and melphalan (BEAM) or BuEM in matched-pair analysis on a planned 2:1 ratio. Eighty-seven patients treated with BEAM who fulfilled the matching criteria were randomly selected. Two-year progression-free survival/overall survival (PFS/OS) were 63.2%/76.7% for BEAM vs. 65.6%/79.8% for BuEM after 64.7 and 42.7 months, respectively. Furthermore, marginally better PFS and OS were noted in Hodgkin lymphoma (HL) after BuEM. In multivariate analysis, PFS was superior in HL, chemosensitive disease and complete remission post-transplant. BEAM correlated with faster engraftment, reduced infections, less mucositis and liver toxicity, and BuEM with less need for blood cell and platelet transfusions and granulocyte colony-stimulating factor administration. In conclusion, BuEM was well tolerated and equally highly efficacious as BEAM for non-Hodgkin lymphoma and offered marginally significantly improved PFS and OS in HL with acceptable toxicity and zero mortality.
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Sakellari
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Despoina
authors.initials: D
authors.lastname: Mallouri
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Batsis
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Chrysa
authors.initials: C
authors.lastname: Apostolou
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Varnavas
authors.initials: V
authors.lastname: Konstantinou
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Eleni-Maria
authors.initials: EM
authors.lastname: Abela
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Douka
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Marvaki
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Karypidis
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Michalis
authors.initials: M
authors.lastname: Iskas
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Baliakas
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Panayotis
authors.initials: P
authors.lastname: Kaloyannidis
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Yannaki
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Damianos
authors.initials: D
authors.lastname: Sotiropoulos
authors.affiliation: b Hellenic Cooperative Oncology Group (HeCOG) , Athens , Greece.
authors.forename: Giorgos
authors.initials: G
authors.lastname: Kouvatseas
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Smias
authors.affiliation: a Hematology Department and BMT Unit , "George Papanicolaou" Hospital , Thessaloniki , Greece.
authors.forename: Achilles
authors.initials: A
authors.lastname: Anagnostopoulos
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002066:Busulfan / Q000008:administration & dosage; D002330:Carmustine / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D016555:Matched-Pair Analysis; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009367:Neoplasm Staging; D011034:Podophyllotoxin / Q000627:therapeutic use; D012189:Retrospective Studies; D016019:Survival Analysis; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003561:Cytarabine; D002066:Busulfan; D011034:Podophyllotoxin; D008558:Melphalan; D002330:Carmustine
keywords: Autologous hematopoietic cell transplant; busulfan; conditioning regimen; lymphoma