title: Novel regimens prior to autologous stem cell transplantation for the management of adults with relapsed/refractory non-Hodgkin lymphoma and Hodgkin lymphoma: alternatives to BEAM conditioning.
abstract: High-dose therapy (HDT) followed by autologous stem cell transplant (ASCT) is the standard treatment for relapsed or refractory non-Hodgkin and Hodgkin lymphoma. Until recently, carmustine, etoposide, cytarabine and melphalan (BEAM) was the most commonly used conditioning regimen in this setting, given its acceptable efficacy and tolerability. Despite reasonable success with BEAM, carmustine is associated with a number of acute and late toxicities. Moreover, recent supply and cost issues for this agent have created an urgent need for alternative conditioning regimens. As such, etoposide and melphalan (VP16/MEL) or busulfan, cyclophosphamide, and etoposide (BuCyE) are currently being used with limited success. A number of novel conditioning regimens that replace carmustine with other agents are under investigation, which may provide effective alternatives to BEAM. In considering novel agents to replace carmustine, bendamustine may provide the best alternative, as demonstrated by the results of a number of phase II, multicenter, controlled studies.
authors.affiliation: a Haematology and Haematopoietic Stem Cell Transplant Center, AORMN , Pesaro , Italy ;
authors.forename: Alessandro
authors.initials: A
authors.lastname: Isidori
authors.affiliation: b IMPACT Medicom Inc. , Toronto , ON , Canada.
authors.forename: Anna
authors.initials: A
authors.lastname: Christofides
authors.affiliation: a Haematology and Haematopoietic Stem Cell Transplant Center, AORMN , Pesaro , Italy ;
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Visani
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002330:Carmustine / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000009:adverse effects / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm; 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*; D008558:Melphalan / Q000009:adverse effects / Q000627:therapeutic use; D011034:Podophyllotoxin / Q000009:adverse effects / Q000627:therapeutic use; D012008:Recurrence; D012074:Remission Induction; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D011034:Podophyllotoxin; D008558:Melphalan; D002330:Carmustine
keywords: Autologous stem cell transplant; Hodgkin lymphoma; conditioning; non-Hodgkin lymphoma; refractory; relapsed