Key Laboratory of Cancer Prevention and Therapy, Department of Hematology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China.
Sci Rep. 2021 Feb 19;11(1):4273. doi: 10.1038/s41598-021-81944-8.
High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (ASCT) is still a consolidation treatment choice for relapsed/refractory B-cell non-Hodgkin's lymphoma (NHL) patients and some aggressive B-cell NHL as frontline therapy. Due to the shortage of carmustine, we switched to idarubicin-substituted BEAC (IEAC) conditioning regimen. We retrospectively compared the outcomes of 72 aggressive B-cell NHL patients treated with IEAC or BEAC regimens followed by ASCT as upfront consolidative treatment. The median time to neutrophil and platelet reconstitution showed no difference between IEAC and BEAC groups. IEAC regimen was well tolerated without increase of adverse events. Transplant-related mortality didn't occur. The overall survival (OS) and progression-free survival (PFS) of IEAC group (33 and 23 months) were a little longer than that of BEAC group (30 and 18 months). However, due to the small sample numbers, there's no significant difference in OS and PFS between IEAC and BEAC group with DLBCL or MCL. Multivariate analysis showed that AnnArbor staging, IPI score, lactate dehydrogenase level, remission of disease, modified regimen were related with PFS and OS. In conclusion, IEAC regimen was well tolerated and replacement with idarubicin could be an alternative when carmustine was not available.
大剂量化疗后自体造血干细胞移植(ASCT)仍然是复发/难治性 B 细胞非霍奇金淋巴瘤(NHL)患者和某些侵袭性 B 细胞 NHL 的巩固治疗选择,也是一线治疗方案。由于卡莫司汀短缺,我们改用伊达比星替代 BEAC(IEAC)预处理方案。我们回顾性比较了 72 例接受 IEAC 或 BEAC 方案预处理后行 ASCT 作为一线巩固治疗的侵袭性 B 细胞 NHL 患者的结果。IEAC 组和 BEAC 组的中性粒细胞和血小板重建的中位时间无差异。IEAC 方案耐受性良好,无不良反应增加。无移植相关死亡。IEAC 组的总生存(OS)和无进展生存(PFS)(33 个月和 23 个月)略长于 BEAC 组(30 个月和 18 个月)。然而,由于样本数量较小,IEAC 组与 BEAC 组在 DLBCL 或 MCL 中的 OS 和 PFS 无显著差异。多因素分析显示,AnnArbor 分期、IPI 评分、乳酸脱氢酶水平、疾病缓解、改良方案与 PFS 和 OS 相关。总之,IEAC 方案耐受性良好,当卡莫司汀不可用时,伊达比星替代可作为一种选择。