Objective: To evaluate the efficacy and safety of the BeEAM (Bendamustine + Etoposide + Cytarabine + Melphalan) conditioning regimen for autologous hematopoietic stem cell transplantation (ASCH) in lymphoma patients.

Methods: This study is a retrospective, multicenter clinical study, analyzing the clinical data of 167 lymphoma patients (NHL=152, HL=15) who underwent ASCH after BeEAM conditioning regimen from January 2021 to March 2024 in five tertiary teaching hospitals including the Cancer Hospital affiliated to Chongqing University. The clinical characteristics, transplant-related adverse reactions, hematopoietic reconstitution, efficacy, and survival status of the patients were assessed.

Results: The median age of the patients was 49 years (11-71 years), mainly male (58.0%). Most patients had aggressive B-cell lymphoma, including diffuse large B-cell lymphoma (53.2%), Burkitt's lymphoma (3.0%), as well as mantle cell lymphoma (4.2%), Hodgkin's lymphoma (8.9%), follicular lymphoma (1.2%), and peripheral T-cell lymphoma (16.7%). Among them, 132 patients (78.90%) were in stages III/IV, 111 patients (66.40%) had intermediate-high/ high risk IPI scores, and 60 patients (36.00%) had large tumor masses. Before the intensive therapy, the median number of chemotherapy courses was 2 times (1-9 times), and 78 patients (46.6%) received transplantation after second-line chemotherapy. The median number of CD34+ cells infused after conditioning was 5.14 (2.04-15.68). After transplantation, 8 patients had poor platelet engraftment, and the rest achieved hematopoietic reconstruction. The median time for good engraftment of neutrophils and platelets in peripheral blood post-transplant was 10.42 days (6-30 days) and 11.88 days (5-34 days), respectively.

The median follow-up time of the patients was 15.0 months (7.0, 48 months). During the follow-up period, 71 patients had PD (progressive disease), 31 patients died, the 2-year PFS (progression-free survival) was 56.1%, and the 2-year OS (overall survival) was 84.1%. Among the 167 patients during the conditioning process, 31 patients (18.5%) had infections, 13 patients (7.8%) had severe gastrointestinal reactions, 6 patients (3.6%) had acute kidney injury, and 3 patients (1.8%) had cardiac toxicity.

Conclusion: The BeEAM regimen is effective and well-tolerated for conditioning in autologous hematopoietic stem cell transplantation for lymphoma patients.

Disclosures

No relevant conflicts of interest to declare.

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2024
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