A treatment regimen utilizing bendamustine, etoposide, cytarabine, and melphalan (BeEAM) as conditioning therapy prior to autologous hematopoietic stem cell transplantation (HSCT) can be effective for the treatment of several lymphomas, including diffuse large B-cell lymphoma (DLBCL), according to a study published in Leukemia & Lymphoma.
Conditioning treatment using BeEAM prior to HSCT yielded a 75% progression-free survival (PFS) rate at 24 months for all patients tested, including a 65% rate for the subgroup of patients with DLBCL. The overall survival (OS) rate was 83% at 24 months with a 69% OS for patients with DLBCL. A complete remission (CR) as the best response was observed in 73% of the overall patient group.
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“Our study showed excellent PFS and OS outcomes of the BeEAM regimen, with results comparable to data available in the literature,” the authors wrote.
While the treatment was found to be effective, it also resulted in a high rate of infectious adverse events, including febrile neutropenia in 98% of patients, mucositis in 72%, and colitis in 60%. Of the patients who experienced febrile neutropenia, at least 1 pathogen was identified in 54% of those patients. Clostridium dificil, Escherichia coli, and Candida spp were the 3 most common pathogens identified.
Two patients died from infectious complications during the study period, with 1 being due to COVID-19 infection.
Noninfectious toxicities were also reported, with 19% of patients experiencing renal failure, 13% liver damage, 13% diarrhea, 9% atrial fibrillation, 7% digestive hemorrhage, 7% adrenal insufficiency, and 5% deep venous thrombosis.
“The toxicity profile of BeEAM significantly varies from one study to another, and guidelines suggesting optimal dose of bendamustine and supportive care are currently lacking,” the authors observed.
During the retrospective study, hospital charts for 55 patients with lymphoma who received treatment with BeEAM were collected and reviewed. The median patient age was 59 years, and over half of the patients were male (64%). The majority of patients had stage IV lymphoma (69%) according to the Lugano classification, and 39% had more than 1 extranodal involvement.
The patient group included 26 patients with DLBCL, 14 with Hodgkin lymphoma, 14 with mantle cell lymphoma, and 1 with follicular lymphoma.
Plante MÉ, Feng X, Boudreault JS. Single-center retrospective study assessing the efficacy and safety of BeEAM (bendamustine, etoposide, cytarabine, melphalan) as conditioning regimen for autologous hematopoietic stem cell transplantation. Leuk Lymphoma. Published online May 8, 2023. doi:10.1080/10428194.2023.2203790