BEAM conditioning regimen and autologous peripheral stem cell transplantation in patients with malignant lymphoma.
- Author:
Jin No PARK
1
;
Young Seon HONG
;
Chee Won SONG
;
Seok Goo CHO
;
Jong Wook LEE
;
Woo Sung MIN
;
Chun Choo KIM
;
Kyung Shick LEE
Author Information
1. Catholic Hematopoietic Stem Cell Transplantation Cencer.
- Publication Type:Original Article
- Keywords:
BEAM;
Autologous stem cell transplantation;
Lymphoma
- MeSH:
Blood Platelets;
Cytarabine;
Disease-Free Survival;
Drug Therapy;
Etoposide;
Follow-Up Studies;
Herpes Zoster;
Humans;
Lymphoma*;
Lymphoma, Non-Hodgkin;
Otitis;
Peripheral Blood Stem Cell Transplantation*;
Recurrence;
Typhlitis
- From:Korean Journal of Medicine
2001;61(3):255-263
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The long-term survival in patients with non-Hodgkin's lymphoma (NHL) after conventional chemotherapy is about 35% and the rest of the patients tend to have relapse. So, in relapsed or refractory NHL, the outcome of patients undergoing high-dose chemotherapy and autologous peripheral stem cell transplantation (APBSCT) was evaluated, and the main prognostic factors were determined. METHODS: 17 patients with relapsed or resistant NHL (5 complete response group, 7 partial response group, 4 primary refractory group, 1 resistant relapse) underwent BEAM (carmustine, etoposide, cytarabine, melphalan) chemotherapy and APBSCT between July 1997 and February 1999. RESULTS: The median follow-up duration was 17 months (range: 4-47). The response rate was 58.3% (complete response 33.3%, partial response 25.0%) in 12 patients in whom complete response group was not included. The 2-year, 3-year overall response rate were 41.2%, 27.5%, respectively. And 2-year progression free survival was 35.3%. The disease status before high-dose chemotherapy was the only significant prognostic factor in determining overall survival (univariate p=.024, multivariate p=.059) and progression free survival (univariate p=.013, multivariate p=.026). Patients with complete response to salvage regimen had better overall survival (p=.021) and progression free survival (p=.008) than patients with refractory response. WBC (> or = 1,000/uL) was recovered at the median 11 days (range; 8-24), and platelet (> or = 50,000/uL) was recovered at the median 18 days (range; 9-44). There was no treatment-related death and no grade 3 and 4 toxicity. Neutropenic infection was in 4 patients (1 Herpes zoster, 1 typhlitis, 1 perianal infection, 1 otitis externa). CONCLUSION: The pre-transplant disease status was the main prognostic factor. Patients with complete response to salvage regimen had the significant benefit in survival from high-dose chemotherapy and APBSCT, but patients with refractory or resistant relapsed NHL did not have any significant benefit.
