Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 1814-1822 |
| Number of pages | 9 |
| Journal | Biology of Blood and Marrow Transplantation |
| Volume | 24 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 2018 |
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A Comparison of the Conditioning Regimens BEAM and FEAM for Autologous Hematopoietic Stem Cell Transplantation in Lymphoma: An Observational Study on 1038 Patients From Fondazione Italiana Linfomi. / Olivieri, J; Mosna, F; Pelosini, M; Fama, A; Rattotti, S; Giannoccaro, M; Carli, G; Tisi, MC; Ferrero, S; Sgherza, N; Mazzone, AM; Marino, D; Calimeri, T; Loseto, G; Saraceni, F; Tomei, G; Sica, S; Perali, G; Codeluppi, K; Billio, A; Olivieri, A; Orciuolo, E; Matera, R; Stefani, PM; Borghero, C; Ghione, P; Cascavilla, N; Lanza, F; Chiusolo, P; Finotto, S; Federici, I; Gherlinzoni, F; Centurioni, R; Fanin, R; Zaja, F; Course, on behalf of the Fondazione Italiana Linfomi Postgraduate Master.
In: Biology of Blood and Marrow Transplantation, Vol. 24, No. 9, 2018, p. 1814-1822.Research output: Contribution to journal › Article
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TY - JOUR
T1 - A Comparison of the Conditioning Regimens BEAM and FEAM for Autologous Hematopoietic Stem Cell Transplantation in Lymphoma: An Observational Study on 1038 Patients From Fondazione Italiana Linfomi
AU - Olivieri, J
AU - Mosna, F
AU - Pelosini, M
AU - Fama, A
AU - Rattotti, S
AU - Giannoccaro, M
AU - Carli, G
AU - Tisi, MC
AU - Ferrero, S
AU - Sgherza, N
AU - Mazzone, AM
AU - Marino, D
AU - Calimeri, T
AU - Loseto, G
AU - Saraceni, F
AU - Tomei, G
AU - Sica, S
AU - Perali, G
AU - Codeluppi, K
AU - Billio, A
AU - Olivieri, A
AU - Orciuolo, E
AU - Matera, R
AU - Stefani, PM
AU - Borghero, C
AU - Ghione, P
AU - Cascavilla, N
AU - Lanza, F
AU - Chiusolo, P
AU - Finotto, S
AU - Federici, I
AU - Gherlinzoni, F
AU - Centurioni, R
AU - Fanin, R
AU - Zaja, F
AU - Course, on behalf of the Fondazione Italiana Linfomi Postgraduate Master
PY - 2018
Y1 - 2018
N2 - BEAM (carmustine [bis-chloroethylnitrosourea (BCNU)]-etoposide-cytarabine-melphalan) chemotherapy is the standard conditioning regimen for autologous stem cell transplantation (ASCT) in lymphomas. Owing to BCNU shortages, many centers switched to fotemustine-substituted BEAM (FEAM), lacking proof of equivalence. We conducted a retrospective cohort study in 18 Italian centers to compare the safety and efficacy of BEAM and FEAM regimens for ASCT in lymphomas performed from 2008 to 2015. We enrolled 1038 patients (BEAM = 607, FEAM = 431), of which 27% had Hodgkin lymphoma (HL), 14% indolent non-Hodgkin lymphoma (NHL), and 59% aggressive NHL. Baseline characteristics including age, sex, stage, B-symptoms, extranodal involvement, previous treatments, response before ASCT, and overall conditioning intensity were well balanced between BEAM and FEAM; notable exceptions were median ASCT year (BEAM = 2011 versus FEAM = 2013, P <.001), Sorror score ≥3 (BEAM = 15% versus FEAM = 10%, P = .017), and radiotherapy use (BEAM = 18% versus FEAM = 10%, P <.001). FEAM conditioning resulted in higher rates of gastrointestinal and infectious toxicities, including severe oral mucositis grade ≥3 (BEAM = 31% versus FEAM = 44%, P <.001), and sepsis from Gram-negative bacteria (mean isolates/patient: BEAM = .1 versus FEAM = .19, P <.001). Response status at day 100 post-ASCT (overall response: BEAM = 91% versus FEAM = 88%, P = .42), 2-year overall survival (83.9%; 95% confidence interval [CI], 81.5% to 86.1%) and progression-free survival (70.3%; 95% CI, 67.4% to 73.1%) were not different in the two groups. Mortality from infection was higher in the FEAM group (subhazard ratio, 1.99; 95% CI, 1.02 to 3.88; P = .04). BEAM and FEAM do not appear different in terms of survival and disease control. However, due to concerns of higher toxicity, fotemustine substitution in BEAM does not seem justified, if not for easier supply. © 2018 The American Society for Blood and Marrow Transplantation
AB - BEAM (carmustine [bis-chloroethylnitrosourea (BCNU)]-etoposide-cytarabine-melphalan) chemotherapy is the standard conditioning regimen for autologous stem cell transplantation (ASCT) in lymphomas. Owing to BCNU shortages, many centers switched to fotemustine-substituted BEAM (FEAM), lacking proof of equivalence. We conducted a retrospective cohort study in 18 Italian centers to compare the safety and efficacy of BEAM and FEAM regimens for ASCT in lymphomas performed from 2008 to 2015. We enrolled 1038 patients (BEAM = 607, FEAM = 431), of which 27% had Hodgkin lymphoma (HL), 14% indolent non-Hodgkin lymphoma (NHL), and 59% aggressive NHL. Baseline characteristics including age, sex, stage, B-symptoms, extranodal involvement, previous treatments, response before ASCT, and overall conditioning intensity were well balanced between BEAM and FEAM; notable exceptions were median ASCT year (BEAM = 2011 versus FEAM = 2013, P <.001), Sorror score ≥3 (BEAM = 15% versus FEAM = 10%, P = .017), and radiotherapy use (BEAM = 18% versus FEAM = 10%, P <.001). FEAM conditioning resulted in higher rates of gastrointestinal and infectious toxicities, including severe oral mucositis grade ≥3 (BEAM = 31% versus FEAM = 44%, P <.001), and sepsis from Gram-negative bacteria (mean isolates/patient: BEAM = .1 versus FEAM = .19, P <.001). Response status at day 100 post-ASCT (overall response: BEAM = 91% versus FEAM = 88%, P = .42), 2-year overall survival (83.9%; 95% confidence interval [CI], 81.5% to 86.1%) and progression-free survival (70.3%; 95% CI, 67.4% to 73.1%) were not different in the two groups. Mortality from infection was higher in the FEAM group (subhazard ratio, 1.99; 95% CI, 1.02 to 3.88; P = .04). BEAM and FEAM do not appear different in terms of survival and disease control. However, due to concerns of higher toxicity, fotemustine substitution in BEAM does not seem justified, if not for easier supply. © 2018 The American Society for Blood and Marrow Transplantation
U2 - 10.1016/j.bbmt.2018.05.018
DO - 10.1016/j.bbmt.2018.05.018
M3 - Article
VL - 24
SP - 1814
EP - 1822
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 9
ER -