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BEAM vs FEAM high-dose chemotherapy: retrospective study in lymphoma patients undergoing autologous stem cell transplant

Bone Marrow Transplantation volume 53, pages 1051–1054 (2018)Cite this article

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The most widely used high-dose chemotherapy (HDC) before autologous stem cell transplant (ASCT) is BEAM regimen (carmustine, etoposide, cytarabine, and melphalan) [1, 2], which is considered the gold standard both in United States and Europe [3, 4]. However, carmustine has been often substituted by other molecules due to its difficult supplying and high costs [3, 5]. In Italy, the most frequently used alternative regimen is FEAM (fotemustine, etoposide, cytarabine, melphalan), in which carmustine is replaced by fotemustine, a third-generation chloroethyl-nitrosourea with ability to cross the blood–brain barrier and a more favorable pulmonary toxicity profile, however not available in all European countries [6]. Even though only two phase-2 studies have been until now published [7, 8], the Italian Regulatory Agency for medical products granted reimbursement of fotemustine by the National Health Service as component of FEAM regimen. Based on these considerations, we aimed to investigate in a retrospective study the comparison between BEAM and FEAM regimen in terms of efficacy and safety in lymphoma patients undergoing ASCT.

From January 2007 to January 2017, 362 consecutive lymphoma patients undergoing ASCT after BEAM (n = 200) and FEAM (n = 162) were analyzed by reviewing clinical records in two centers of Rome (Sapienza University n = 218 and Regina Elena National Cancer Institute n = 144), both accredited according to JACIE standards. Selection for HDC was only based on carmustine availability. In particular, due to difficult supplying of carmustine, FEAM regimen was planned in all patients from September 2011 to August 2015 in Sapienza University and Regina Elena Institute, respectively. All patients had signed a specific informed consent for HDC and for data analysis.

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Author contributions

Concept and design: FM and SC; development of methodology: FM, DG; acquisition of data: FM, SMT, MA, MDC, ASe, SG, DR, LP, FPa, IP, ADR, FPi, AR, ASp; data analysis and interpretation: FM, DG, SC, AM; technical and statistical support: DG, EP, MCanf; manuscript writing: FM; critical review of the manuscript: AM, SC, MCant.

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Authors and Affiliations

  1. Hematology and Stem Cell Transplant Unit, Experimental and Clinical Oncology Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy

    F. Marchesi, S. Gumenyuk, D. Renzi, F. Palombi, F. Pisani, A. Romano, A. Spadea, E. Papa & A. Mengarelli

  2. Hematology Unit, Department of Cellular Biotechnologies and Hematology, Policlinico Umberto I, La Sapienza University, Rome, Italy

    S. Capria, S. M. Trisolini, M. Ansuinelli, M. D. Caputo, A. Serrao & A. Di Rocco

  3. Biostatistical Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy

    D. Giannarelli

  4. Hematology Unit, Tor Vergata University, Rome, Italy

    L. Pupo, I. Provenzano & M. Cantonetti

  5. Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy

    M. Canfora

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  1. F. Marchesi
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Correspondence to F. Marchesi.

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Marchesi, F., Capria, S., Giannarelli, D. et al. BEAM vs FEAM high-dose chemotherapy: retrospective study in lymphoma patients undergoing autologous stem cell transplant. Bone Marrow Transplant 53, 1051–1054 (2018). https://doi.org/10.1038/s41409-018-0120-x

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  • DOI: https://doi.org/10.1038/s41409-018-0120-x

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