Safety and efficacy of bendamustine in the conditioning regimen for autologous stem cell transplantation in patients with relapsed/refractory lymphoma
- Author:
Munira SHABBIR-MOOSAJEE
1
;
Samad JEHANGIR
;
Sobiya SAWANI
;
Tariq MUHAMMED
;
Natasha ALI
;
Usman SHEIKH
;
Salman ADIL
Author Information
- Publication Type:Original Article
- Keywords: Bendamustine; Toxicity; Autologous stem cell transplant; Lymphoma
- MeSH: Acute Kidney Injury; Bendamustine Hydrochloride; Blood Platelets; Carmustine; Cytarabine; Diarrhea; Etoposide; Follow-Up Studies; Hodgkin Disease; Humans; Hyperbilirubinemia; Kidney; Liver; Lymphoma; Lymphoma, Non-Hodgkin; Lymphoma, T-Cell, Peripheral; Melphalan; Mortality; Neutrophils; Stem Cell Transplantation; Stem Cells
- From:Blood Research 2019;54(2):108-113
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Bendamustine is an attractive option for the management of both de novo and relapsed lymphomas. It is being increasingly used in the conditioning regimen for autologous stem cell transplantation (SCT) and can be an alternative to the traditionally-used carmustine. In this study, we aimed to determine the safety and efficacy of bendamustine in the conditioning regimen for autologous SCT in refractory/relapsed lymphomas. METHODS: We designed a descriptive study to evaluate bendamustine in combination with etoposide, cytarabine, and melphalan (BeEAM) in the conditioning regimen for autologous SCT. RESULTS: Fourteen patients (median age, 28 yr) with Hodgkin's lymphoma (HL) (N=8), non-Hodgkin's lymphomas (NHL) (N=5), or peripheral T-cell lymphoma, not otherwise specified (PTCL NOS) (N=1) were included in the study. A median number of 5.95×10⁶ CD34+ cells/kg were transfused. Median times to absolute neutrophil count and platelet engraftment were 17 days and 24 days, respectively. The 100-day transplantation mortality rate was 28% (4 patients). Eight patients (57.14%) had GII-III acute kidney injury, four patients (28.5%) had GIII-IV hyperbilirubinemia, and twelve patients (85%) had GII-III diarrhea. After 3 months, 37% (5 patients) and 21.4% (3 patients) demonstrated complete response and partial response, respectively. The median follow-up was 5.5 months (15 days–19 mo). At the final follow-up, 7 patients (50%) were alive and in CR. CONCLUSION: Our study showed that bendamustine is a potentially toxic agent in the conditioning regimen for autologous SCT, resulting in significant liver, kidney, and gastrointestinal toxicity. Further studies are required to assess its safety and efficacy at reduced doses.
