Summary:
Between January 1996 and July 2002, 72 patients with non-Hodgkin's lymphoma or Hodgkin's disease underwent high-dose chemotherapy with autologous stem cell transplant conditioned with either cyclophosphamide, etoposide, carmustine (CEB) or carmustine, etoposide, cytarabine, melphalan (BEAM) at a single institution. In all, 52 patients received CEB and 20 patients received the BEAM regimen. Patient characteristics that were significantly different between the two groups are tumor grade and extranodal involvement (P=0.0196, 0.0341, respectively). Regimen-related toxicities examined yielded only diarrhea occurring at a higher rate in the BEAM group (81 vs 51%, P=0.0026), although cases were milder (92 vs 57%). Patients treated with CEB developed mucositis at a slightly higher rate (79%) than patients treated with BEAM (75%), but this difference did not reach statistical significance. However, the mucositis that occurred within the BEAM group was predominately mild (67%) in contrast to the predominance of moderate to severe cases in the CEB group (74%). In addition, patients treated with CEB required growth factor support for a longer time than patients treated with BEAM (P=0.0399). Response rates were high in both groups, with trends favoring the BEAM group. Overall survival was higher after treatment with BEAM than with CEB (84 vs 60%).
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Alessandrino EP, Bernasconi P, Colombo A et al. Pulmonary toxicity following carmustine-based preparative regimens and autologous peripheral blood progenitor cell transplantation in hematological malignancies. Bone Marrow Transplant 2000; 25: 309–313.
Patti C, Majolino I, Scime R et al. High-dose cyclophosphamide, etoposide and BCNU (CVB) with autologous stem cell rescue in malignant lymphomas. Eur J Haematol 1993; 51: 18–24.
Reece DE, Barnett MJ, Conners JM et al. Intensive chemotherapy with cyclophosphamide, carmustine, and etoposide followed by autologous bone marrow transplantation for relapsed Hodgkin's disease. J Clin Oncol 1991; 9: 1871–1879.
Reece DE, Nevill TJ, Sayegh A et al. Regimen-related toxicity and non-relapse mortality with high-dose cyclophosphamide, carmustine (BCNU) and etoposide (VP16-213) (CBV) and CBV plus cisplatin (CBVP) followed by autologous stem cell transplantation in patients with Hodgkin's disease. Bone Marrow Transplant 1999; 23: 1131–1138.
Schmitz N, Glass B, Dreger P et al. High-dose chemotherapy and hematopoietic stem cell rescue in patients with relapsed Hodgkin's disease. Ann Hematol 1993; 66: 251.
Wheeler C, Antin JH, Churchill WH et al. Cyclophosphamide, carmustine, and etoposide with autologous bone marrow transplantation in refractory Hodgkin's disease and Non-Hodgkin's lymphoma: a dose-finding study. J Clin Oncol 1990; 8: 648–656.
Argiris A, Seropian S, Cooper DL . High-dose BEAM chemotherapy with autologous peripheral blood-progenitor-cell transplantation for unselected patients with primary refractory or relapsed Hodgkin's disease. Ann Oncol 2000; 11: 665–672.
Fleming DR, Wolff SN, Fay JW et al. Protracted results of dose-intensive therapy using cyclophosphamide, carmustine, and continuous infusion etoposide with autologous stem cell support in patients with relapse or refractory Hodgkin's disease: a phase II study from the North American Marrow Transplant Group. Leuk Lymphoma 1999; 35: 91–98.
Mills W, Chopra R, McMillan A et al. BEAM chemotherapy and autologous bone marrow transplantation for patients with relapsed or refractory non-Hodgkin's lymphoma. J Clin Oncol 1995; 13: 588–595.
Bierman PJ, Anderson JR, Freeman MB et al. High-dose chemotherapy followed by autologous hematopoietic rescue for Hodgkin's disease patients following first relapse after chemotherapy. Ann Oncol 1996; 7: 151–156.
Chopra R, McMillan AK, Linch DC et al. The place of high-dose BEAM therapy and autologous bone marrow transplantation in poor-risk Hodgkin's disease. A single-center eight-year study of 155 patients. Blood 1993; 81: 1137–1145.
Lindley C, Finley RS, Shord SS . Adverse effects of chemotherapy. In: Koda-Kimble MA, Young LY (eds.). Applied Therapeutics: The Clinical Use of Drugs, 7th edn. Lippincott Williams & Wilkins: Philadelphia, 2001; pp 87-1–87-41.
Jantunen E, Kuittinen T, Nousiainen T . BEAC or BEAM for high-dose therapy in patients with Non-Hodgkin's lymphoma? A single centre analysis on toxicity and efficacy. Leuk Lymphoma 2003; 44: 1151–1158.
Lindley C, Shord SS, Finley RS . Neoplastic disorders and their treatment: general principles. In: Koda-Kimble MA, Young LY (eds). Applied Therapeutics: The Clinical Use of Drugs, 7th edn. Lippincott Williams & Wilkins: Philadelphia, 2001; pp 86-1–86-33.
Spinolo JA, Jagannath S, Dicke KA et al. High-dose combination chemotherapy with cyclophosphamide, carmustine, etoposide, and autologous bone marrow transplantation in 60 patients with relapsed Hodgkin's disease: The M.D. Anderson experience. Recent Results Cancer Res 1989; 117: 233–238.
Caballero MD, Rubio V, Rifon J et al. BEAM chemotherapy followed by autologous stem cell support in lymphoma patients: analysis of efficacy, toxicity and prognostic factors. Bone Marrow Transplant 1997; 20: 451–458.
Salar A, Sierra J, Gandarillas M et al. Autologous stem cell transplantation for clinically aggressive non-Hodgkin's lymphoma: the role of preparative regimens. Bone Marrow Transplant 2001; 27: 405–412.
Arranz R, Tomas JF, Gil-Fernandez JJ et al. Autologous stem cell transplantation (ASCT) for poor prognostic Hodgkin's disease (HD): comparative results with two CBV regimens and importance of disease status at transplant. Bone Marrow Transplant 1998; 21: 779–786.
Bierman PJ, Bagin RG, Jagannath S et al. High dose chemotherapy followed by autologous hematopoietic rescue in Hodgkin's disease: long-term follow-up in 128 patients. Ann Oncol 1993; 4: 767–773.
Finley RS, Treish IM, Lindley CM . Hematologic malignancies. In: Koda-Kimble MA, Young LY (eds.). Applied Therapeutics: The Clinical Use of Drugs, 7th edn. Lippincott Williams & Wilkins: Philadelphia, 2001; pp 88-1–88-37.
Acknowledgements
We owe our sincere gratitude and thanks to Lora Lee and Betsy Gilpin of the Biostatistics Shared Resources at UCSD for statistical analysis.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wang, E., Chen, Y., Corringham, S. et al. High-dose CEB vs BEAM with autologous stem cell transplant in lymphoma. Bone Marrow Transplant 34, 581–587 (2004). https://doi.org/10.1038/sj.bmt.1704637
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1704637
Keywords
This article is cited by
-
Association and risk factors of healthcare-associated infection and burden of illness among chemotherapy-induced ulcerative mucositis patients
Clinical Oral Investigations (2022)
-
Phase II study of safety and efficacy of BEB (bendamustine, etoposide, and busulfan) conditioning regimen for autologous stem cell transplantation in non-Hodgkin lymphoma
Annals of Hematology (2020)
-
BEAM or BUCYVP16-conditioning regimen for autologous stem-cell transplantation in non-Hodgkin’s lymphomas
Bone Marrow Transplantation (2019)
-
Advantages of non-cryopreserved autologous hematopoietic stem cell transplantation against a cryopreserved strategy
Bone Marrow Transplantation (2018)
-
Evaluation of Lymphoma Patients Receiving High-Dose Therapy and Autologous Stem Cell Transplantation: Experience of a Single Center
Indian Journal of Hematology and Blood Transfusion (2017)