Evaluating Bendamustine-EAM conditioning chemotherapy for patients with mantle cell lymphoma

This study evaluated the safety and effectiveness of bendamustine-EAM (Be-EAM) chemotherapy for patients with mantle cell lymphoma (MCL) before a stem cell transplant. This study found that this regimen improved survival outcomes compared to standard regimens.

Stem cell transplants (SCT) remain the standard of care for patients with MCL. SCT replaces the patient’s cancer cells with healthy stem cells. Before the transplant, high-dose chemotherapy is given to get rid of any remaining cancer cells. This is called a conditioning regimen.

BEAM (carmustine, etoposide, cytarabine, melphalan) is the most common conditioning regimen. However, carmustine (BICNU) has been associated with side effects on the lungs. In the Be-EAM regimen, bendamustine (Treanda) replaces carmustine. Whether this regimen is safer and more effective than standard BEAM for patients with MCL before a SCT is unclear.

This study had 168 patients with MCL. 60 patients were given Be-EAM and 108 patients were given BEAM. Patients were followed for an average of 36 to 37 months.

Before the transplant, more patients in the Be-EAM group had no signs of cancer compared to BEAM (82% vs. 60%). Overall, 88% of all patients were still alive 3 years later. The type of conditioning regimen did not affect overall survival. However, significantly more patients in the Be-EAM group were still alive 3 years later without the cancer getting worse compared to the BEAM group (84% vs. 63%).

3 years later, more patients in the Be-EAM group were in remission (no signs of disease) compared to the BEAM group (84% vs. 81%). Be-EAM was associated with a 62.3% lower risk of tumor growth or spread.

46% of patients in the Be-EAM group developed acute kidney failure. However, this resolved within 6 to 21 days after the transplant. 78% of patients had sore gums or mouth sores. Infections were also reported (46%).

This study found that the Be-EAM regimen improved survival outcomes for patients with MCL compared to standard BEAM chemotherapy. However, due to side effects, the authors suggest that more studies are needed to confirm the benefits of Be-EAM for these patients.

This study looked back in time to analyze data. Also, more patients in the Be-EAM group had rituximab (Rituxan) treatment after the transplant (57% vs. 4%). These differences may affect long-term treatment outcomes. More studies are needed to determine if BeEAM can benefit patients with MCL.