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22 October 2019 : Original article  

BEAM-Modified Conditioning Therapy with Cisplatin+Dexamethasone Instead of Carmustine Prior to Autologous Hematopoietic Stem Cell Transplantation (HSCT) in Patients with Hodgkin and Non-Hodgkin Lymphoma

Ana Lucia Ron-Magaña12ABCDEF, Omar Eduardo Fernandez-Vargas23CDEF, Esperanza Barrera-Chairez23ADF, Carlos Silvestre Ron-Guerrero4CDF, Ana Jaqueline Bañuelos-Ávila1ABCDEF*

DOI: 10.12659/AOT.918259

Ann Transplant 2019; 24:584-587

Abstract

BACKGROUND: High-dose chemotherapy followed by autologous hematopoietic stem cell transplant has proven useful in relapsed or refractory cases of Hodgkin and non-Hodgkin lymphoma. BEAM (carmustine, etoposide, cytarabine, melphalan) is frequently used as a conditioning regimen; however, the high cost and limited availability of BCNU hinders its use in Mexico.

MATERIAL AND METHODS: Between January 2013 and February 2019, refractory or relapsing HL and NHL patients were treated with an autologous HSCT conditioned with cisplatin+dexamethasone as substitution for BCNU in BEAM.

RESULTS: Four HL patients and 6 NHL patients were included; 60% were male, the average age was 34.5±15.2 years, the median follow-up was 19.1 months, and 70% had a complete response after transplant. OS at 12 months was 63% for NHL and 100% for HL. Time to hematological recovery was 17.6±2.8 days; all patients developed grade III/IV neutropenia and thrombocytopenia, and 8 patients had transplant-related infections.

CONCLUSIONS: This retrospective study based on real-world data introduces the option of substituting carmustine with cisplatin+dexamethasone, with a similar response, expected lower cost, and better accessibility in developing nations.

Keywords: Bone Marrow Transplantation, Hodgkin Disease, Lymphoma, Non-Hodgkin, Transplantation Conditioning, Antineoplastic Combined Chemotherapy Protocols, Carmustine, Cisplatin, Combined Modality Therapy, Cytarabine, Dexamethasone, Melphalan, Middle Aged, Pilot Projects, Podophyllotoxin, Retrospective Studies, Transplantation, Autologous, young adult

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358