title: BEAM Conditioning Regimen Has Higher Toxicity Compared With High-Dose Melphalan for Salvage Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma.
abstract: BACKGROUND
  Salvage autologous stem cell transplantation (ASCT) is increasingly used for eligible patients with multiple myeloma (MM) for progress after conventional chemotherapy. We recently used BEAM (BCNU, etoposide, cytarabine, and melphalan) conditioning for patients with myeloma receiving salvage ASCT whose disease progressed after a first ASCT with high-dose melphalan (HDM). We report safety and efficacy of BEAM salvage ASCT in MM in comparison with HDM-based salvage ASCT.
  
  
  METHODS
  Between 2008 and 2013, 43 consecutive patients received salvage ASCT for MM (19 with HDM; 24 with BEAM).
  
  
  RESULTS
  The BEAM group had a higher incidence of infections, intensive level of care, and fever (19 vs. 13 patients; P = .02), whereas the melphalan group had a higher incidence of mucositis (7 vs. 2 patients; P = .03). Other toxicities were not different. There was no significant difference in disease status and response rate before and after salvage ASCT between the 2 groups. The median time of follow-up after salvage ASCT was 5 and 9 months and the median progression-free survival (PFS) times were 7.7 and 12.1 months (P = .82) for BEAM and melphalan, respectively.
  
  
  CONCLUSIONS
  BEAM seemed to be associated with higher toxicity with comparable efficacy to HDM ASCT. Longer follow-up is needed to determine whether there is any significant difference in PFS between the 2 groups.
authors.affiliation: Department of Oncology, Wayne State University, Detroit, MI. Electronic address: mkumaran.2006@gmail.com.
authors.forename: Muthu
authors.initials: M
authors.lastname: Veeraputhiran
authors.affiliation: Department of Internal Medicine, Wayne State University, Detroit, MI.
authors.forename: Tania
authors.initials: T
authors.lastname: Jain
authors.affiliation: Department of Oncology, Wayne State University, Detroit, MI; Department of Internal Medicine, Wayne State University, Detroit, MI; Blood and Marrow Stem Cell Transplant Program, Wayne State University, Detroit, MI.
authors.forename: Abhinav
authors.initials: A
authors.lastname: Deol
authors.affiliation: Department of Oncology, Wayne State University, Detroit, MI; Department of Internal Medicine, Wayne State University, Detroit, MI; Blood and Marrow Stem Cell Transplant Program, Wayne State University, Detroit, MI.
authors.forename: Lois
authors.initials: L
authors.lastname: Ayash
authors.affiliation: Biostatistics Core, Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Seongho
authors.initials: S
authors.lastname: Kim
authors.affiliation: Biostatistics Core, Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Gregory
authors.initials: G
authors.lastname: Dyson
authors.affiliation: Department of Oncology, Wayne State University, Detroit, MI; Department of Internal Medicine, Wayne State University, Detroit, MI; Blood and Marrow Stem Cell Transplant Program, Wayne State University, Detroit, MI.
authors.forename: Divaya
authors.initials: D
authors.lastname: Bhutani
authors.affiliation: Department of Oncology, Wayne State University, Detroit, MI; Department of Internal Medicine, Wayne State University, Detroit, MI; Blood and Marrow Stem Cell Transplant Program, Wayne State University, Detroit, MI; Department of Immunology and Microbiology, Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Lawrence G
authors.initials: LG
authors.lastname: Lum
authors.affiliation: Department of Oncology, Wayne State University, Detroit, MI; Department of Internal Medicine, Wayne State University, Detroit, MI; Blood and Marrow Stem Cell Transplant Program, Wayne State University, Detroit, MI.
authors.forename: Voravit
authors.initials: V
authors.lastname: Ratanatharathorn
authors.affiliation: Department of Oncology, Wayne State University, Detroit, MI; Department of Internal Medicine, Wayne State University, Detroit, MI; Blood and Marrow Stem Cell Transplant Program, Wayne State University, Detroit, MI.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Uberti
authors.affiliation: Department of Oncology, Wayne State University, Detroit, MI; Department of Internal Medicine, Wayne State University, Detroit, MI; Blood and Marrow Stem Cell Transplant Program, Wayne State University, Detroit, MI.
authors.forename: Muneer H
authors.initials: MH
authors.lastname: Abidi
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002330:Carmustine / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D018572:Disease-Free Survival; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D008297:Male; D008558:Melphalan / Q000627:therapeutic use*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D016879:Salvage Therapy / Q000379:methods; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous / Q000379:methods
chemical_list: D003561:Cytarabine; D005047:Etoposide; D008558:Melphalan; D002330:Carmustine
keywords: Autologous stem cell transplantation; BEAM; Conditioning therapy; Engraftment; Salvage therapy