Turkish Journal of Hematology Volume: 33 - Issue: 3
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
Turk J Hematol 2016;<strong>33</strong>:209-215<br />
Esbah O, et al: Comparison <strong>of</strong> Conditioning Regimens: BEAM vs. High-Dose ICE<br />
Head-to-head comparisons <strong>of</strong> different conditioning regimens<br />
in relapsed/refractory lymphoma patients before AHCT are<br />
scarce. Jo et al. observed superior OS and event-free survival at<br />
2 years in patients on BEAM compared to BEAC regimens (62.4%<br />
vs. 32.1% and 62.4% vs. 28.6%, respectively). However, diarrhea<br />
and mucositis were more frequent in patients <strong>of</strong> the BEAM arm<br />
[9]. In their single-center analysis, Jantunen et al. reported similar<br />
efficacy <strong>of</strong> BEAM and BEAC conditioning regimens in terms <strong>of</strong><br />
OS and progression-free survival in patients undergoing AHCT<br />
for NHL, but BEAM was found more toxic to the gastrointestinal<br />
system [16]. In recent years the BEAM regimen was also<br />
compared with the CEB (carboplatin, etoposide, and bleomycin)<br />
regimen with better OS in favor <strong>of</strong> BEAM [14], but other<br />
studies reported conflicting results [15]. Salar et al. reported<br />
Spanish GEL/TAMO registry data including 395 consecutively<br />
autografted diffuse large B-cell lymphoma (DLBCL) patients.<br />
Figure 1. Kaplan-Meier plots <strong>of</strong> disease-free survival following<br />
autologous hematopoietic stem cell transplantation according<br />
to conditioning regimens. Three-year disease-free survival rates<br />
were 63±13% (BEAM) vs. 42±15% (hICE) (p=0.187).<br />
Figure 2. Kaplan-Meier plots <strong>of</strong> overall survival following<br />
autologous hematopoietic stem cell transplantation according<br />
to conditioning regimens. Three-year overall survival rates were<br />
56±8% (BEAM) vs. 58±10% (hICE) (p=0.781).<br />
Table 2. Mobilization yield, engraftment kinetics, efficacy, and toxicity pr<strong>of</strong>iles <strong>of</strong> conditioning regimens.<br />
BEAM (n=37) hICE (n=25) p<br />
CD34+ cell counts, median (min-max) 5.9 (2.5-16.7) 5.7 (3.5-11.29) 0.36<br />
Febrile neutropenic days, median (min-max) 4 (1-10) 3 (1-12) 0.79<br />
Neutrophil engraftment, days, median (min-max) 11 (8-19) 12 (9-34) 0.24<br />
Platelet engraftment, days, median (min-max) 12 (8-16) 12 (10-25) 0.24<br />
Hospitalization days, median (min-max) 24 (12-67) 26 (20-50) 0.53<br />
Nausea/vomiting, n (grade ≥2) 17 21 0.04<br />
Diarrhea, n (grade ≥2) 22 20 0.09<br />
Mucositis, n (grade ≥2) 3 13 0.002<br />
Nephrotoxicity, n, (grade ≥2) 1 12
Change language