Plante Marie-Élaine, Feng Xue, Boudreault Jean-Samuel
Division of Hematology and Oncology, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Canada.
Leuk Lymphoma. 2023 Jul-Aug;64(7):1234-1242. doi: 10.1080/10428194.2023.2203790. Epub 2023 May 8.
One of the most widely accepted conditioning regimens for hematopoietic stem cell transplantation (HSCT) is BEAM (carmustine, etoposide, cytarabine, melphalan). However, a recent increase in the cost of carmustine has limited its use bringing our institution to replace carmustine with bendamustine. This observational retrospective single-center study aims to report the efficacy and safety of the BeEAM regimen. 55 patients with diffuse large B-cell lymphoma (47%), Hodgkin lymphoma (25%), mantle cell lymphoma (25%), or follicular lymphoma (2%) were included. Progression-free survival (PFS) at 24 months was 75% and overall survival (OS) was 83%. Treatment-related mortality was 4%. The most common adverse effects were febrile neutropenia (98%), mucositis (72%) and colitis (60%). Our study demonstrated excellent efficacy of the BeEAM regimen. However, the toxicity profile of BeEAM significantly varies from one study to another, and guidelines suggesting optimal dose of bendamustine and supportive care are currently lacking.
造血干细胞移植(HSCT)中最广泛接受的预处理方案之一是BEAM(卡莫司汀、依托泊苷、阿糖胞苷、美法仑)。然而,最近卡莫司汀成本的增加限制了其使用,促使我们机构用苯达莫司汀替代卡莫司汀。这项观察性回顾性单中心研究旨在报告BeEAM方案的疗效和安全性。纳入了55例弥漫性大B细胞淋巴瘤患者(47%)、霍奇金淋巴瘤患者(25%)、套细胞淋巴瘤患者(25%)或滤泡性淋巴瘤患者(2%)。24个月时的无进展生存期(PFS)为75%,总生存期(OS)为83%。治疗相关死亡率为4%。最常见的不良反应是发热性中性粒细胞减少(98%)、粘膜炎(72%)和结肠炎(60%)。我们的研究证明了BeEAM方案具有出色的疗效。然而,BeEAM的毒性特征在不同研究中差异很大,目前缺乏关于苯达莫司汀最佳剂量和支持治疗的指南。