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Outcomes of EAM conditioned autologous haematopoietic SCT for lymphoma. A matched pairs retrospective single-centre study analysis

Bone Marrow Transplantation volume 48, pages 1486–1487 (2013)Cite this article

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BEAM (BCNU, Etoposide, Cytarabine and Melphalan) chemotherapy followed by auto-SCT is superior to salvage chemotherapy alone, in patients with Hodgkin lymphoma (HL)1 and non-Hodgkin lymphoma (NHL)2 who have relapsed disease. However, BCNU is associated with potentially lethal pulmonary interstitial toxicity, in a dose-dependent manner.3 The incidence of BCNU-associated pneumonitis in published trials has ranged from 3% (ref. 1) to 17% (ref. 4), depending on definition, but the risk of pneumonitis in patients with pre-existing lung disease is unknown. Our practice has been to omit BCNU when pre-transplant lung function tests showed a lung carbon monoxide transfer coefficient (KCO) of less than 50% or when there was pre-existing lung disease.

At our centre, between 2000 and 2010, 338 adults have been transplanted with BEAM conditioning, and 23 patients with an identical regimen but without BCNU (EAM). BEAM chemotherapy involved cumulative doses of BCNU at 300 mg/m2, etoposide at 800 mg/m2, cytarabine at 1600 mg/m2 and melphalan at 140 mg/m2. OS and PFS were estimated by the Kaplan–Meier method. OS was measured from the time of transplantation till death. PFS was measured from the time of transplantation till death or disease progression. A 1:1 matched-pair analysis, based on age and sex, was used to compare the outcomes of patients transplanted with a BEAM regimen to those with the EAM regimen. The log-rank test was used to compare differences between the survival distributions.

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  1. Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK

    J Loke, J Ward, P Mahendra, S Chaganti & R Malladi

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  1. J Loke
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  2. J Ward
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  3. P Mahendra
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Correspondence to J Loke.

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Loke, J., Ward, J., Mahendra, P. et al. Outcomes of EAM conditioned autologous haematopoietic SCT for lymphoma. A matched pairs retrospective single-centre study analysis. Bone Marrow Transplant 48, 1486–1487 (2013). https://doi.org/10.1038/bmt.2013.90

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