Berber Ilhami, Erkurt Mehmet Ali, Nizam Ilknur, Koroglu Mustafa, Kaya Emin, Kuku Irfan, Bag Harika Gozukara
Department of Hematology, Inonu University, Faculty of Medicine Malatya, Turkey.
Department of Biostatistics and Medical Informatics, Inonu University School of Medicine Malatya, Turkey.
Int J Clin Exp Med. 2015 Sep 15;8(9):16308-14. eCollection 2015.
High-dose chemotherapy (HDC) applied together with autologous stem cell transplantation (ASCT) is a commonly used treatment modality in patients with malignant lymphoma. At present, there is a limited number of studies which compare toxicity and efficacy of various high-dose regimens applied in the treatment of malignant lymphoma. For this reason, the aim of this study was to investigate the efficacy and toxicity of BuCyE (busulfan, cyclophosphamide and etoposide) and BEAM (carmustine, etoposide, cytarabine and melphalan) preparative regimens in the patients with malignant lymphoma scheduled for autologous stem cell transplantation. Between November, 2010 and April, 2015, 42 patients with relapsed or refractory malignant lymphoma who underwent autologous stem cell transplantation following BEAM (n=11) and BuCyE (n=31) preparative regimens were analyzed at Bone Marrow Transplantation Unit of TurgutOzal Medicine Center in Turkey. The groups were compared in terms of patient characteristics, hematopoietic engraftment time, toxicity profiles and survival. No significant differences were detected between the groups with regard to age, gender distribution, international prognostic index, ASCT indications, disease status at the time of ASCT and type of lymphoma (P>0.05). Median number of infused CD34+ cells/kg, neutrophil and platelet engraftment statuses of BuCyE and BEAM groups were found to be similar (P>0.05). More patients in BuCyE group developed mucositis and nausea, but this difference was not statistically significant (P>0.05). A similar statistically insignificant difference was seen in that infectious complications occurred more commonly in BEAM group (P>0.05). Overall survival and event-free survival rates were not significantly different between the groups (P>0.05). BuCyE is a conditioning regimen which can be effectively used as an alternative to BEAM in the patients with malignant lymphoma undergoing ASCT. Moreover, toxicity rates of both regimens are similar. In order to comprehend the effect of each HDC regimen, further evidence-based data obtained from the studies involving larger sample sizes are required.
大剂量化疗（HDC）联合自体干细胞移植（ASCT）是恶性淋巴瘤患者常用的治疗方式。目前，比较用于治疗恶性淋巴瘤的各种大剂量方案的毒性和疗效的研究数量有限。因此，本研究的目的是调查白消安、环磷酰胺和依托泊苷（BuCyE）预处理方案以及卡莫司汀、依托泊苷、阿糖胞苷和美法仑（BEAM）预处理方案对计划进行自体干细胞移植的恶性淋巴瘤患者的疗效和毒性。2010年11月至2015年4月期间，在土耳其图尔古特·奥扎尔医学中心的骨髓移植科，对42例接受BEAM（n = 11）和BuCyE（n = 31）预处理方案后进行自体干细胞移植的复发或难治性恶性淋巴瘤患者进行了分析。比较了两组患者的特征、造血植入时间、毒性特征和生存率。两组在年龄、性别分布、国际预后指数、ASCT适应症、ASCT时的疾病状态和淋巴瘤类型方面未检测到显著差异（P>0.05）。发现BuCyE组和BEAM组每公斤输注的CD34+细胞中位数、中性粒细胞和血小板植入状态相似（P>0.05）。BuCyE组更多患者出现黏膜炎和恶心，但这种差异无统计学意义（P>0.05）。BEAM组感染并发症更常见，也存在类似的无统计学意义的差异（P>0.05）。两组的总生存率和无事件生存率无显著差异（P>0.05）。在接受ASCT的恶性淋巴瘤患者中，BuCyE作为一种预处理方案可有效替代BEAM。此外，两种方案的毒性发生率相似。为了了解每种大剂量化疗方案的效果，需要从涉及更大样本量的研究中获得更多基于证据的数据。
