顺铂作为卡莫司汀在 BEAM 为基础的预处理方案中替代物用于淋巴瘤患者自体造血干细胞移植的可行性和安全性研究。
Cisplatin as a Viable and Secure Alternative to Carmustine in BEAM-Based Conditioning for Autologous Hematopoietic Stem Cell Transplantation in Patients with Lymphoma.
机构信息
Department of Hematology, Instituto Nacional de Cancerologia, Mexico City, Mexico.
Department of Hematology, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Guadalajara, Mexico.
出版信息
Transplant Proc. 2024 Jul-Aug;56(6):1446-1453. doi: 10.1016/j.transproceed.2024.05.034. Epub 2024 Jul 27.
BACKGROUND
High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT) is a standard treatment for relapsed/refractory lymphoma patients. Yet, the widespread use of BEAM is hindered by carmustine accessibility. This study evaluates the efficacy and safety of PEAM (Cisplatin, Etoposide, Cytarabine, and Melphalan) versus BEAM in auto-HSCT for Hodgkin (HL) and non-Hodgkin lymphoma (NHL) patients.
METHODS
We conducted a retrospective single-center study of adult lymphoma patients who received PEAM or BEAM pretransplant conditioning between January 2004 to December 2022, comparing efficacy and safety outcomes.
RESULTS
Among 143 patients (median age of 33 years, 58% males), 55 had HL, and 88 had NHL. The overall response rate (ORR) was 86.7% for PEAM and 72.3% for BEAM, and the relapse rate (RR) was lower for PEAM than BEAM (22.9% vs 45.6%). Median time to relapse (TTR) and overall survival (OS) were not reached for either group. PEAM exhibited a shorter time to both neutrophil (NE) and platelet (PE) engraftment compared to BEAM (10 vs 12 days), with a more tolerable gastrointestinal (GI) toxicity profile.
CONCLUSIONS
Both BEAM and PEAM showed similar outcomes, demonstrating comparable efficacy in terms of ORR, TTR, and OS for both HL and NHL patients. However, PEAM-conditioning was associated with a shorter time to engraftment and fewer GI adverse events.
背景
大剂量化疗后自体造血干细胞移植（auto-HSCT）是复发/难治性淋巴瘤患者的标准治疗方法。然而，由于卡莫司汀的可及性，BEAM 的广泛应用受到阻碍。本研究评估了在 Hodgkin（HL）和非霍奇金淋巴瘤（NHL）患者的 auto-HSCT 中，PEAM（顺铂、依托泊苷、阿糖胞苷和马法兰）与 BEAM 的疗效和安全性。
方法
我们进行了一项回顾性单中心研究，纳入了 2004 年 1 月至 2022 年 12 月期间接受 PEAM 或 BEAM 预处理的成人淋巴瘤患者，比较了疗效和安全性结果。
结果
在 143 名患者中（中位年龄为 33 岁，58%为男性），55 名患有 HL，88 名患有 NHL。PEAM 的总体缓解率（ORR）为 86.7%，BEAM 的 ORR 为 72.3%，PEAM 的复发率（RR）低于 BEAM（22.9% vs 45.6%）。两组患者均未达到中位复发时间（TTR）和总生存（OS）。PEAM 与 BEAM 相比，中性粒细胞（NE）和血小板（PE）植入的时间更短（10 天 vs 12 天），胃肠道（GI）毒性谱更可耐受。
结论
BEAM 和 PEAM 均显示出相似的结果，在 HL 和 NHL 患者的 ORR、TTR 和 OS 方面均显示出相当的疗效。然而，PEAM 预处理与植入时间更短和较少的 GI 不良事件相关。
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