BACKGROUND: The combination of carmustine, etoposide, cytarabine and melphalan (BEAM) is an effective autologous transplantation preparative regimen for lymphoma and has little toxicity, but the feasibility and tolerance of BEAM as a preparative regimen for allogeneic transplantation has not been established. PATIENTS AND METHODS: Thirty adults with primary refractory or recurrent intermediate- or low-grade lymphoma were treated on a prospective phase II study with carmustine 300 mg/m2 i.v. day -6, etoposide 200 mg/m2 i.v. followed by cytarabine 200 mg/m2 i.v. twice daily days -5 to -2, melphalan 140 mg/m2 i.v. day -1, and marrow or blood stem cells from an HLA-identical donor on day 0. Tacrolimus and methotrexate were used to prevent graft-vs.-host disease (GVHD). RESULTS: Median time from transplantation was 20 mos (range 6-32 months). Median maximal regimen-related toxicity grade was 2, and four patients (13%) had a grade 3-4 regimen-related toxicity. Two patients had idiopathic interstitial pneumonitis. One patient had primary graft failure, and a second had autologous reconstitution documented at three months posttransplant. Grades 2-4 acute GVHD occurred in 31%, grades 3-4 in 16%, and chronic GVHD in 54%. Day-100 survival was 70%. Twenty-three patients achieved a complete response. The two-year relapse rate was 23%, survival was 48%, and disease-free survival (DFS) was 42%. CONCLUSIONS: BEAM supports engraftment of allogeneic transplants and is a tolerable preparative regimen for allogeneic transplantation for lymphoma.
BACKGROUND: The combination of carmustine, etoposide, cytarabine and melphalan (BEAM) is an effective autologous transplantation preparative regimen for lymphoma and has little toxicity, but the feasibility and tolerance of BEAM as a preparative regimen for allogeneic transplantation has not been established. PATIENTS AND METHODS: Thirty adults with primary refractory or recurrent intermediate- or low-grade lymphoma were treated on a prospective phase II study with carmustine 300 mg/m2 i.v. day -6, etoposide 200 mg/m2 i.v. followed by cytarabine 200 mg/m2 i.v. twice daily days -5 to -2, melphalan 140 mg/m2 i.v. day -1, and marrow or blood stem cells from an HLA-identical donor on day 0. Tacrolimus and methotrexate were used to prevent graft-vs.-host disease (GVHD). RESULTS: Median time from transplantation was 20 mos (range 6-32 months). Median maximal regimen-related toxicity grade was 2, and four patients (13%) had a grade 3-4 regimen-related toxicity. Two patients had idiopathic interstitial pneumonitis. One patient had primary graft failure, and a second had autologous reconstitution documented at three months posttransplant. Grades 2-4 acute GVHD occurred in 31%, grades 3-4 in 16%, and chronic GVHD in 54%. Day-100 survival was 70%. Twenty-three patients achieved a complete response. The two-year relapse rate was 23%, survival was 48%, and disease-free survival (DFS) was 42%. CONCLUSIONS: BEAM supports engraftment of allogeneic transplants and is a tolerable preparative regimen for allogeneic transplantation for lymphoma.
Authors: Kamal Chamoun; Denái R Milton; Celina Ledesma; Ken H Young; Elias J Jabbour; Gheath Alatrash; Paolo Anderlini; Qaiser Bashir; Stefan O Ciurea; David Marin; Jeffrey J Molldrem; Amanda L Olson; Betul Oran; Uday R Popat; Gabriela Rondon; Richard E Champlin; Alison M Gulbis; Issa F Khouri Journal: Biol Blood Marrow Transplant Date: 2019-03-01 Impact factor: 5.742
Authors: Vaishalee P Kenkre; Sarah Horowitz; Andrew S Artz; Chuanhong Liao; Kenneth S Cohen; Lucy A Godley; Justin P Kline; Sonali M Smith; Wendy Stock; Koen van Besien Journal: Leuk Lymphoma Date: 2010-12-10
Authors: Hillard M Lazarus; Mei-Jie Zhang; Jeanette Carreras; Brandon M Hayes-Lattin; Asli Selmin Ataergin; Jacob D Bitran; Brian J Bolwell; César O Freytes; Robert Peter Gale; Steven C Goldstein; Gregory A Hale; David J Inwards; Thomas R Klumpp; David I Marks; Richard T Maziarz; Philip L McCarthy; Santiago Pavlovsky; J Douglas Rizzo; Thomas C Shea; Harry C Schouten; Shimon Slavin; Jane N Winter; Koen van Besien; Julie M Vose; Parameswaran N Hari Journal: Biol Blood Marrow Transplant Date: 2009-10-04 Impact factor: 5.742
Authors: Ulas D Bayraktar; Qaiser Bashir; Muzaffar Qazilbash; Richard E Champlin; Stefan O Ciurea Journal: Biol Blood Marrow Transplant Date: 2012-08-24 Impact factor: 5.742
Authors: Koen van Besien; Jeanette Carreras; Philip J Bierman; Brent R Logan; Arturo Molina; Roberta King; Gene Nelson; Joseph W Fay; Richard E Champlin; Hillard M Lazarus; Julie M Vose; Parameswaran N Hari Journal: Biol Blood Marrow Transplant Date: 2009-03-09 Impact factor: 5.742