Comparing conditioning regimens before stem cell transplantation for patients with Hodgkin lymphoma

This study evaluated the safety and effectiveness of two chemotherapy regimens before autologous stem cell transplantation (ASCT) for patients with Hodgkin lymphoma (HL). This study concluded that BEAM conditioning before ASCT significantly improved the outcomes of these patients.

About 20 – 30% of patients with HL relapse or develop disease that does not respond to treatment. High-dose chemotherapy followed by ASCT is the standard treatment for these patients. This type of chemotherapy is called a conditioning regimen. It is given before the transplant to get rid of any remaining cancer cells.

BEAM (carmustine, etoposide, cytarabine, melphalan) and BUCYVP16 (busulfan, cyclophosphamide, etoposide) are two of the most common regimens. Whether BEAM is safer and more effective conditioning regimen than BUCYVP16 for patients with recurrent or nonresponsive HL remains unclear.

This study included 233 patients with HL that was recurrent or did not respond to treatment. 128 patients received BEAM conditioning. 105 patients received BUCYVP16 conditioning. Patients had received an average of 2 to 3 prior lines of therapy. Patients were followed-up for an average of 3.8 to 4.2 years.

Significantly more patients in the BEAM group remained alive without tumor growth or spread (progression-free survival; PFS) 3 years later compared to the BUCYVP16 group (70% vs. 45%). At 5 years, PFS was still significantly higher for the BEAM group (66% vs. 33%).

Significantly more patients in the BEAM group were still alive 3 years later compared to the BUCYVP16 group (88% vs. 72%). At 5 years, this rate was 79% vs. 54%. Significantly fewer patients in the BEAM group experienced a relapse 3 years later compared to the BUCYVP16 group (28% vs. 49%). At 5 years, this rate was 29% vs. 56%.

Significantly more patients in the BUCYVP16 group had a severe sore mouth and/or gums compared to the BEAM group (50% vs. 26%).

This study concluded that BEAM conditioning before ASCT was safer and more effective than the BUCYVP16 regimen for patients with HL.

This study was retrospective, meaning it looked back in time to analyze data. More studies are needed to confirm these results.