Evaluating chemotherapy regimens before stem cell transplantation for patients with non-Hodgkin’s lymphoma

This study evaluated the effectiveness of BEAM chemotherapy versus BUCYVP16 chemotherapy in patients with non-Hodgkin’s lymphoma (NHL) before autologous stem cell transplantation (ASCT). This study concluded that these regimens were similarly safe and effective for these patients before ASCT.

For patients with NHL that has come back or has stopped responding to treatment, conventional chemotherapy may not be effective. High-dose chemotherapy followed by ASCT is the typical next step 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 conditioning regimens. Whether BEAM is a safer and more effective conditioning regimen than BUCYVP16 for patients with recurrent NHL remains unclear.

This study involved 678 patients with recurrent or non-responsive NHL. All patients received conditioning therapy before undergoing ASCT. 269 patients received BEAM and 409 patients received BUCYVP16. Patients were followed-up for an average of 3.9 to 4.3 years.

Before the transplant, slightly more patients in the BUCYVP16 group had a complete disappearance of cancer compared to the BEAM group (51% vs. 50%). On average, more patients in the BEAM group were still alive 3 years later compared to the BUCYVP16 group (75% vs. 69%). At 5 years, this rate was 66% vs. 59%.

On average, patients in the BEAM group survived longer without tumor growth or spread compared to the BUCYVP16 group (4.3 years vs. 3.9 years). 59% vs. 54% of patients were still alive 3 years later without tumor growth or spread. At 5 years, this rate was 46% vs. 44%.

Significantly more patients treated with BUCYVP16 reported severe sore mouth or gums compared to the BEAM group (56% vs. 24%). Significantly more patients treated with BEAM developed a decrease in blood flow inside the liver due to blocked veins (3% vs. 0%).

BEAM chemotherapy was significantly associated with a 56% better overall survival compared to BUCYP16 chemotherapy.

This study concluded that these regimens were similarly safe and effective for patients with NHL before ASCT. However, the authors suggest that BEAM was associated with a significantly better survival compared to BUCYVP16.

This study was retrospective, meaning it looked back in time to analyze data. More studies are needed to determine the most effective conditioning regimen for patients with recurrent or non-responsive NHL.