Evaluating BEB chemotherapy for patients with non-Hodgkin’s lymphoma

This study evaluated the safety and effectiveness of BEB (busulfan, etoposide, bendamustine) chemotherapy for patients with non-Hodgkin’s lymphoma (NHL). This study found that BEB chemotherapy was effective and well-tolerated in these patients.

Autologous stem cell transplantation (ASCT) is a standard treatment for patients with NHL that has relapsed (returned) after initial treatment. During ASCT, a patient’s stem cells are removed from the blood or bone marrow. Next, high-dose chemotherapy is given to reduce or eliminate the remaining cancer cells. Then, the collected healthy stem cells are given back to the patient.

There are different options for high-dose chemotherapy, including BEAM and BEAC. However, these regimens include carmustine (Bicnu), which has side effects and is not always available. BEB is an alternative chemotherapy regimen for use before ASCT. How safe and effective this regimen is for patients with NHL is unclear.

This study included 31 patients with NHL. 74.2% of patients had diffuse large B-cell lymphoma (DLBCL). 29.0% of patients had cancer that came back after previous treatment. In this study, all patients received BEB chemotherapy followed by ASCT. Patients were followed-up for an average of 15 months.

After chemotherapy, 81.5% of patients had no signs of cancer. This went up slightly to 87.1% at three months after the transplant.

At follow-up, 19.4% (6 patients) had cancer come back or spread. 73.0% of patients were still alive 2 years later without cancer getting worse. Overall, 89.9% of patients were still alive 2 years later.

48.4% of patients developed a high fever. Most of these patients (41.9%) had low white blood cell count with fever. However, the fever quickly resolved. Diarrhea (93.5%) and vomiting (51.6%) were common. Low red blood cell count (48.4%) and low platelet count (48.4%) were also reported. 

51.6% of patients had serious side effects. The most common one was diarrhea (19.5%).

This study found that BEB chemotherapy was effective before ASCT for patients with NHL, with manageable side effects.

This study had a small number of patients. More than half of the patients in this study had ASCT as a first-line treatment. This study did not compare BEB to other chemotherapy regimens. More studies are needed.