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Conditioning Regimens

Fotemustine plus etoposide, cytarabine and melphalan (FEAM) as a new conditioning regimen for lymphoma patients undergoing auto-SCT: a multicenter feasibility study

Bone Marrow Transplantation volume 45, pages 1147–1153 (2010)Cite this article

Abstract

BEAM is a widely used conditioning regimen for relapsed/refractory lymphoma patients undergoing auto-SCT. We conducted a multicenter study with an alternative regimen (fotemustine plus etoposide, cytarabine and melphalan (FEAM)) in which BCNU was substituted by the chloroethylnitrosourea fotemustine (FTM). Eighty-four patients with relapsed/refractory Hodgkin's (n=20) and non-Hodgkin's lymphoma (n=64) were conditioned with a FEAM regimen (FTM 150 mg/m2 on days –7, –6, etoposide 200 mg/m2 and cytarabine 400 mg/m2 on days –5, –4, –3, –2 and melphalan 140 mg/m2 on day –1). Patients were evaluated for toxicity and engraftment parameters. Median times to neutrophil (>500 × 109/l) and plt (>20 000 × 109/l) engraftment were 11 and 13 days, respectively. Grade 3 mucositis occurred in 19 patients (23%), while G3 nausea/vomiting and G3 diarrhea were observed in 13 (15%) and 6 (7%) patients, respectively. No severe hepatic, renal or pulmonary toxicity was detected. Seven patients (7%) experienced G4 mucositis, while no other G4 toxicities or unexpected adverse events of any grade were recorded. Transplant-related mortality was 2.4%. We conclude that a FEAM regimen is feasible and safe. Although toxicity and engraftment times compared favorably with BEAM, longer follow-up is needed to evaluate fully its efficacy and long-term safety.

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Acknowledgements

We thank the following physicians who participated in the study: Rosella Matera, Ospedale Vito Fazi, Lecce, Potito Rosario Scalzulli, Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Paolo Di Carlo, Ospedale Civile, Pescara. This work was supported in part by a grant to A Pinto from Ministero della Salute, Ricerca Finalizzata FSN, IRCCS, Rome, Italy.

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Authors and Affiliations

  1. Department of Oncology, Oncohematology and Bone Marrow Transplantation Unit, ‘La Maddalena’, Palermo, Italy

    M Musso, R Scalone & A Crescimanno

  2. Hematology-Oncology and Stem Cell Transplantation Unit, National Cancer Institute, Fondazione ‘G Pascale’, IRCCS, Naples, Italy

    G Marcacci & A Pinto

  3. Section of Hematology, University Hospital, St Anna Hospital, Ferrara, Italy

    F Lanza

  4. Hematology Unit, ‘Vito Fazi’ Hospital, Lecce, Italy

    N Di Renzo

  5. Hematology Unit and Bone Marrow Transplantation, IRCSS ‘Casa Sollievo della Sofferenza’, San Giovanni Rotondo (FG), Italy

    N Cascavilla

  6. Department of Hematology, Bone Marrow Transplant Centre, Ospedale Civile, Pescara, Italy

    P Di Bartolomeo

  7. Scientific Department, Italfarmaco S.p.A, Cinisello Balsamo (MI), Italy

    T Perrone

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Dr Tania Perrone is an employee of Italfarmaco S.p.A., Italy. All other authors have no financial or other conflict to declare.

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Musso, M., Scalone, R., Marcacci, G. et al. Fotemustine plus etoposide, cytarabine and melphalan (FEAM) as a new conditioning regimen for lymphoma patients undergoing auto-SCT: a multicenter feasibility study. Bone Marrow Transplant 45, 1147–1153 (2010). https://doi.org/10.1038/bmt.2009.318

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