Evaluating BEAM conditioning for allogeneic stem cell transplantation in patients with relapsed or unresponsive lymphoma

This study evaluated the effectiveness and safety of BEAM (carmustine, etoposide, cytarabine, and melphalan) chemotherapy before allogeneic hematopoietic cell transplantation (alloHCT; transferring healthy cells from a donor) for relapsed or unresponsive lymphoma. This study concluded that alloHCT with BEAM chemotherapy is an alternative treatment option for these high-risk patients.

For patients with relapsed lymphoma, autologous stem cell transplantation (ASCT) is the current standard of care. This involves collecting blood-forming cells from the patient, storing them and giving them back to the same patients after cancer has been cleared. However, patients who experience relapse or do not respond to this treatment tend to have poor outcomes. More effective therapies are needed for these patients. 

One possible treatment option is alloHCT. This procedure involves replacing the patient’s cancer cells with healthy stem cells from a donor. Chemotherapy called a conditioning regimen is given first to kill cancer cells. The effectiveness and safety of BEAM conditioning with alloHCT for patients with relapsed or unresponsive lymphoma remain under investigation.

This study involved 22 patients. They were previously treated with an average of 3.6 lines of therapy. All patients received BEAM chemotherapy before alloHCT. Patients also received tacrolimus (Prograf)/sirolimus (Rapamune) to prevent graft-versus-host disease (donated stem cells attack the patient’s healthy cells; GVHD). Patients were followed-up for an average of 2.6 years. 

At follow-up, 2-year overall survival was 58.3%. 2-year survival without lymphoma-related complications was 45.5%. 31.8% of all patients experienced a relapse 2 years after treatment. 

Overall, 50% of patients experienced short-term GVHD. 45.5% of patients developed moderate to severe, long-term GVHD at 1 year after treatment.

This study concluded that alloHCT with BEAM chemotherapy is an alternative treatment option for high-risk patients with relapsed or unresponsive lymphoma.

This study looked back in time to analyze data. Also, the patient population in this study was small. Further studies with larger patient populations are needed to confirm these results.