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在自体移植前使用苯达莫司汀替代卡氮芥进行硼替佐米(BeEAM)预处理,对淋巴瘤患者是安全有效的。

BeEAM conditioning with bendamustine-replacing BCNU before autologous transplantation is safe and effective in lymphoma patients.

作者信息

Gilli Stefanie, Novak Urban, Taleghani Behrouz Mansouri, Baerlocher Gabriela M, Leibundgut Kurt, Banz Yara, Zander Thilo, Betticher Daniel, Egger Thomas, Rauch Daniel, Pabst Thomas

机构信息

Department of Medical Oncology, University Hospital Bern, 3010, Berne, Switzerland.

Department of Hematology, University Hospital Bern, Berne, Switzerland.

出版信息

Ann Hematol. 2017 Mar;96(3):421-429. doi: 10.1007/s00277-016-2900-y. Epub 2016 Dec 24.

Abstract

BEAM with BCNU is commonly used for conditioning treatment followed by autologous stem cell transplantation (ASCT). However, pulmonary toxicity and availability issues associated with BCNU prompted us to evaluate bendamustine-replacing BCNU (BeEAM). We analyzed 39 lymphoma patients receiving BeEAM conditioning with 200 mg/m bendamustine at days -7 and -6. The median duration until neutrophil recovery was 11 days, and 15 days for platelet recovery (>20 g/L). The most common grade 3/4 non-hematologic toxicities comprised mucosal side effects (27 pts.). Pulmonary toxicity was observed in one patient (2.5%), and one patient died of septic complications. The CR rate increased from 33% to 74% 100 days after ASCT. After a median follow-up of 18.5 months, progression and death each occurred in 11 patients (28%). Median progression-free and overall survival at 2 years were 69% and 72%. Our data suggest that BeEAM conditioning using bendamustine is safe and results in promising survival rates.

摘要

卡莫司汀联合苯达莫司汀(BEAM)常用于预处理治疗,随后进行自体干细胞移植(ASCT)。然而,与卡莫司汀相关的肺部毒性和可用性问题促使我们评估用苯达莫司汀替代卡莫司汀(BeEAM)的方案。我们分析了39例接受BeEAM预处理的淋巴瘤患者,在第-7天和第-6天给予200mg/m²苯达莫司汀。中性粒细胞恢复的中位持续时间为11天,血小板恢复(>20g/L)的中位持续时间为15天。最常见的3/4级非血液学毒性包括黏膜副作用(27例)。1例患者(2.5%)出现肺部毒性,1例患者死于败血症并发症。自体干细胞移植100天后,完全缓解(CR)率从33%提高到74%。中位随访18.5个月后,11例患者(28%)出现疾病进展和死亡。2年时的无进展生存期和总生存期的中位数分别为69%和72%。我们的数据表明,使用苯达莫司汀进行BeEAM预处理是安全的,并且能带来有希望的生存率。

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