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Carmustine replacement in intensive chemotherapy preceding reinjection of autologous HSCs in Hodgkin and non-Hodgkin lymphoma: a review

Bone Marrow Transplantation volume 52, pages 941–949 (2017)Cite this article

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Abstract

High-dose chemotherapy preceding autologous hematopoietic stem cell transplantation (auto-HSCT) is one treatment option for patients with Hodgkin (HL) or non-Hodgkin lymphoma (NHL). The most frequently used intensive chemotherapy is a combination of carmustine (BCNU), etoposide, cytarabine and melphalan (BEAM). However, BCNU is consistently in short supply, and there has been a recent dramatic increase in its cost, necessitating the utilization of conditioning alternatives. The busulfan-based conditioning regimen known as the busulfan–cyclophosphamide–etoposide (BuCyE) combination is the second most-studied conditioning regimen worldwide after BEAM, and it exhibits a benefit/risk ratio that is comparable to that of BEAM. In addition to these two combinations, the present manuscript also summarizes data reported for other conditioning combinations. Owing to the lack of prospective and comparative studies, a comparison of the toxicities and medicoeconomical profiles of these treatments is warranted to identify effective replacements for BCNU-based conditioning.

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Authors and Affiliations

  1. Institut d'hématologie de Basse Normandie, Centre Hospitalier Universiatire, Faculté de médecine, Université de Basse-Normandie, Caen, France

    G Damaj

  2. Microenvironnement Cellulaire et Pathologies, Normandie University, Caen, France

    G Damaj

  3. Hématologie, Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France

    J Cornillon & S Vigouroux

  4. Hématologie et Thérapie Cellulaire, CHU de Bordeaux, Pessac, France

    K Bouabdallah

  5. Hématologie, CHU de Grenoble, Grenoble, France

    R Gressin

  6. Hématologie, CHU de Nantes, Nantes, France

    T Gastinne

  7. Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Lyon, France

    F Ranchon

  8. Hématologie, Hospices Civils de Lyon, Lyon, France

    H Ghésquières & G Salles

  9. Maladies du sang, CHRU de Lille, Lille, France

    I Yakoub-Agha

  10. Hématologie et Thérapie Cellulaire, CHU de Tours, Tours, France

    E Gyan

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  1. G Damaj
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for Lymphoma Study Association and the French Society of Bone Marrow Transplantation and Cellular Therapy

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Correspondence to G Damaj.

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GD received an unrestricted research grant from Mundipharma. The other authors declare no conflict of interest.

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Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Damaj, G., Cornillon, J., Bouabdallah, K. et al. Carmustine replacement in intensive chemotherapy preceding reinjection of autologous HSCs in Hodgkin and non-Hodgkin lymphoma: a review. Bone Marrow Transplant 52, 941–949 (2017). https://doi.org/10.1038/bmt.2016.340

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