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BeEAM conditioning with bendamustine-replacing BCNU before autologous transplantation is safe and effective in lymphoma patients

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Abstract

BEAM with BCNU is commonly used for conditioning treatment followed by autologous stem cell transplantation (ASCT). However, pulmonary toxicity and availability issues associated with BCNU prompted us to evaluate bendamustine-replacing BCNU (BeEAM). We analyzed 39 lymphoma patients receiving BeEAM conditioning with 200 mg/m2 bendamustine at days −7 and −6. The median duration until neutrophil recovery was 11 days, and 15 days for platelet recovery (>20 g/L). The most common grade 3/4 non-hematologic toxicities comprised mucosal side effects (27 pts.). Pulmonary toxicity was observed in one patient (2.5%), and one patient died of septic complications. The CR rate increased from 33% to 74% 100 days after ASCT. After a median follow-up of 18.5 months, progression and death each occurred in 11 patients (28%). Median progression-free and overall survival at 2 years were 69% and 72%. Our data suggest that BeEAM conditioning using bendamustine is safe and results in promising survival rates.

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Acknowledgements

The authors wish to thank the stem cell coordinating team, the stem cell data-management team, the members of the stem cell collection unit, and of the stem cell processing unit associated with the stem cell program at the University Hospital Bern for providing some of the data used in this analysis. Also, the authors wish to thank all staff members involved in the patient care of the patients reported in this study.

Author’s contributions

S.G. performed research, analyzed data, and wrote the paper; U.N., B.M.T., G.M.B., K.L., Y.B., T.Z., D.B., T.E., and D.R. contributed relevant data, reviewed the manuscript, and were involved in the final writing of the paper; T.P. designed research, analyzed data, and wrote the paper.

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Authors and Affiliations

  1. Department of Medical Oncology, University Hospital Bern, 3010, Berne, Switzerland

    Stefanie Gilli, Urban Novak & Thomas Pabst

  2. Department of Hematology, University Hospital Bern, Berne, Switzerland

    Behrouz Mansouri Taleghani & Gabriela M. Baerlocher

  3. Department of Pediatric Hemato-Oncology, Inselspital, University Hospital Bern, Berne, Switzerland

    Kurt Leibundgut

  4. Institute of Pathology, University of Bern, Berne, Switzerland

    Yara Banz

  5. Department of Oncology, Kantonsspital, Lucerne, Switzerland

    Thilo Zander

  6. Department of Oncology, Kantonsspital, Fribourg, Switzerland

    Daniel Betticher

  7. Department of Oncology, Kantonsspital, Solothurn, Switzerland

    Thomas Egger

  8. Department of Oncology, Regionalspital, Thun, Switzerland

    Daniel Rauch

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  1. Stefanie Gilli
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  2. Urban Novak
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  3. Behrouz Mansouri Taleghani
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Correspondence to Thomas Pabst.

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Grant support

This work was supported by a grant from the Swiss Cancer League (KFS-3795-02-2016; to T.P.) and the EMPIRIS Stiftung Zurich (to T.P.).

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Gilli, S., Novak, U., Taleghani, B.M. et al. BeEAM conditioning with bendamustine-replacing BCNU before autologous transplantation is safe and effective in lymphoma patients. Ann Hematol 96, 421–429 (2017). https://doi.org/10.1007/s00277-016-2900-y

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