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Lymphoma

Radioimmunotherapy-augmented BEAM chemotherapy vs BEAM alone as the high-dose regimen for autologous stem cell transplantation (ASCT) in relapsed follicular lymphoma (FL): a retrospective study of the EBMT Lymphoma Working Party

Bone Marrow Transplantation volume 52, pages 1120–1125 (2017)Cite this article

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Abstract

Relapse remains the most common cause of treatment failure in patients receiving autologous stem cell transplantation (ASCT) for follicular lymphoma (FL). The aim of this study was to evaluate the effect of adding radioimmunotherapy or rituximab (R) to BEAM (carmustine, etoposide, ara-c, melphalan) high-dose therapy for ASCT in patients with relapsed FL. Using the European Society for Blood and Marrow Transplantation registry, we conducted a cohort comparison of BEAM (n=1973), Zevalin-BEAM (Z-BEAM) (n=207) and R-BEAM (n=179) and also a matched-cohort analysis of BEAM vs Z-BEAM including 282 and 154 patients, respectively. BEAM, Z-BEAM and R-BEAM groups were well balanced for age, time from diagnosis to ASCT and disease status at ASCT. The cumulative incidences of relapse (IR) at 2 years were 34, 34 and 32% for Z-BEAM, R-BEAM and BEAM, respectively. By multivariate analysis, there were no significant differences with Z-BEAM or R-BEAM compared with BEAM for IR, non-relapse mortality, event-free survival or overall survival. With the caveat that the limitations of registry analyses have to be taken into account, this study does not support adding radioimmunotherapy or R to BEAM in ASCT for relapsed FL. However, we cannot rule out the existence a particular subset of patients who could benefit from Z-BEAM conditioning that cannot be identified in our series, and this should be tested in a randomized trial.

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Acknowledgements

This study was funded by an unrestricted grant from Sepropharm, Munich, Germany.

Author information

Authors and Affiliations

  1. Son Espases University Hospital, Palma de Mallorca, Spain

    L Bento

  2. EBMT LWP Office, Paris, France

    A Boumendil, H Finel, P Dreger & S Montoto

  3. CHU, Nantes, France

    S Le Gouill

  4. Centre Hospitalier Saint-Louis, Paris, France

    S Amorim

  5. Hôpital Bretonneau, Tours, France

    H Monjanel

  6. Institut Paoli Calmettes, Marseille, France

    R Bouabdallah

  7. CHU, Clermont-Ferrand, France

    J O Bay

  8. Centre Leon Berard, Lyon, France

    E Nicolas-Virelizier

  9. Gartnaval General Hospital, Glasgow, UK

    G McQuaker

  10. Spedali Civili, Brescia, Italy

    G Rossi

  11. St James Institute of Oncology, Leeds, UK

    R Johnson

  12. Hôpital Purpan, Toulouse, France

    A Huynh

  13. CHU Lapeyronie, Montpellier, France

    P Ceballos

  14. Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy

    A Rambaldi

  15. Hospices Civils de Lyon, Pierre-Benite, France

    E Bachy

  16. Centre for Clinical Haematology, Birmingham, UK

    R Malladi

  17. Southampton General Hospital, Southampton, UK

    K Orchard

  18. Charles University Hospital, Prague, Czech Republic

    D Pohlreich

  19. Centre Henri Becquerel, Rouen, France

    H Tilly

  20. Bologna University, S. Orsola-Malpighi Hospital, Bologna, Italy

    F Bonifazi

  21. Cliniques Universitaires St Luc, Brussels, Belgium

    X Poiré

  22. CHU, Poitiers, France

    F Guilhot

  23. Klinikum Chemnitz gGmbH, Chemnitz, Germany

    A Haenel

  24. Addenbrookes Hospital, Cambridge, UK

    C Crawley

  25. University Clinic for Internal Medicine–Oncology and Haematology, Klinikum Oldenburg, Oldenburg, Germany

    B Metzner

  26. Department of Haemato-Oncology, St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK

    J Gribben & S Montoto

  27. Nottingham City Hospital, Nottingham, UK

    N H Russell

  28. CHU, Amiens, France

    G Damaj

  29. University College London Hospital, London, UK

    K Thomson

  30. Department of Medicine V, University of Heidelberg, Heidelberg, Germany

    P Dreger

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  1. L Bento
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  2. A Boumendil
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  31. P Dreger
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  32. S Montoto
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on behalf of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation (EBMT)

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Correspondence to S Montoto.

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The authors declare no conflict of interest.

Additional information

Partially presented in abstract form at the 41st Annual Meeting of the European Society for Blood and Marrow Transplantation on the 23 March 2014 and as an oral presentation in 13th International Conference on Malignant Lymphoma on the 17 June 2015.

Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Bento, L., Boumendil, A., Finel, H. et al. Radioimmunotherapy-augmented BEAM chemotherapy vs BEAM alone as the high-dose regimen for autologous stem cell transplantation (ASCT) in relapsed follicular lymphoma (FL): a retrospective study of the EBMT Lymphoma Working Party. Bone Marrow Transplant 52, 1120–1125 (2017). https://doi.org/10.1038/bmt.2017.88

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