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. 2021 Jul 7;11(1):14071.
doi: 10.1038/s41598-021-93516-x.

BeEAM conditioning regimen is a safe, efficacious and economical alternative to BEAM chemotherapy

Logan Hahn  1 , Hyun Lim  2 , Tanner Dusyk  1 , Waleed Sabry  3 , Mohamed Elemary  3 , Julie Stakiw  3 , Pat Danyluk  3 , Mark Bosch  4
Affiliations

BeEAM conditioning regimen is a safe, efficacious and economical alternative to BEAM chemotherapy

Logan Hahn et al. Sci Rep. .

Abstract

In many stem cell transplant centres, BCNU, etoposide, cytarabine and melphalan (BEAM) high-dose chemotherapy (HDCT) has been replaced by the more economic and available bendamustine, etoposide, cytarabine, melphalan (BeEAM) regimen. However, there is a paucity of information on the efficacy and safety of BeEAM HDCT. We describe our experience with BeEAM HDCT in terms of safety, efficacy and cost-savings. We compare overall and progression-free survival to a cohort of patients previously transplanted at our institution with the older BEAM regimen. We performed a retrospective chart review of 41 lymphoma patients undergoing BeEAM HDCT at the Royal University Hospital in Saskatoon, Saskatchewan between 2015 and 2019 to elicit regimen safety in the first 100 days post-transplant. Furthermore, we calculated overall and progression-free survival and constructed corresponding Kaplan-Meier curves, comparing the results to a historical cohort of BEAM patients (n = 86). Finally, we conducted an economic analysis using the financials available at our centre's pharmacy. With regards to BeEAM HDCT, we report a 100-day transplant-related mortality of 2.4%. Additionally, we report acceptable rates of typhlitis (27%), grade III-IV mucositis (4.9%) and grade III-IV nephrotoxicity (2.4%). In terms of overall and progression-free survival, we found no statistical difference between BeEAM and BEAM (p = 0.296; 0.762, respectively). Finally, our economic analysis revealed a net savings of $21,200 CAD per transplant when BeEAM is used in replacement of BEAM. The acceptable safety profile of BeEAM and its comparable efficacy to BEAM are encouraging for the perseverance of this cost-effective HDCT regimen.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Kaplan–Meier analysis of overall survival. Overall survival (OS) in patients who underwent an ASCT with BEAM or BeEAM. ASCT autologous stem cell transplantation, BEAM BCNU, etoposide, cytarabine, melphalan, BeEAM bendamustine, etoposide, cytarabine, melphalan. p values were determined using the log-rank test.
Figure 2
Figure 2
Kaplan–Meier analysis of progression-free survival. Progression-free survival in patients who underwent an ASCT with BEAM or BeEAM. ASCT autologous stem cell transplantation, BEAM BCNU, etoposide, cytarabine, melphalan, BeEAM bendamustine, etoposide, cytarabine, melphalan. p values were determined using the log-rank test.
See this image and copyright information in PMC

References

    1. Philip T, Guglielmi C, Hagenbeek A, Somers R, Van Der Lelie H, Bron D, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma. N. Engl. J. Med. 1995;333(23):1540–1545. doi: 10.1056/NEJM199512073332305. - DOI - PubMed
    1. Gisselbrecht C, Glass B, Mounier N, Gill DS, Linch DC, Trneny M, et al. Salvage regimens with autologous transplantation for relapsed large B-cell lymphoma in the rituximab era. J. Clin. Oncol. 2010;28(27):4184. doi: 10.1200/JCO.2010.28.1618. - DOI - PMC - PubMed
    1. Linch D, Goldstone AH, McMillan A, Chopra R, Hudson GV, Winfield D, et al. Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin's disease: Results of a BNLI randomised trial. Lancet. 1993;341(8852):1051–1054. doi: 10.1016/0140-6736(93)92411-l. - DOI - PubMed
    1. Schmitz N, Pfistner B, Sextro M, Sieber M, Carella AM, Haenel M, et al. Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin's disease: A randomised trial. Lancet. 2002;359(9323):2065–2071. doi: 10.1016/S0140-6736(02)08938-9. - DOI - PubMed
    1. Colita A, Colita A, Bumbea H, Croitoru A, Orban C, Lipan LE, et al. LEAM vs. BEAM vs. CLV conditioning regimen for autologous stem cell transplantation in malignant lymphomas. Retrospective comparison of toxicity and efficacy on 222 patients in the first 100 days after transplant, on behalf of the Romanian society for bone marrow transplantation. Front. Oncol. 2019;9:892. doi: 10.3389/fonc.2019.00892. - DOI - PMC - PubMed

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