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Substituting carmustine for lomustine is safe and effective in the treatment of relapsed or refractory Lymphoma—a retrospective study from the BSBMT (BEAM versus LEAM)

Bone Marrow Transplantation volume 56, pages 730–732 (2021)Cite this article

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The British National Lymphoma Investigation (BNLI) trial comparing carmustine 300 mg/m2, etoposide 200 mg/m2, cytarabine 200 mg/m2 and melphalan 140 mg/m2 (BEAM) with autologous rescue with mini-BEAM in the Lancet in 1993 [1], established BEAM as the ‘gold standard’ conditioning regimen for patients with relapsed Hodgkin lymphoma (HL) in the UK. Subsequently, the ‘Parma Study’ reported significant benefit from the carmustine containing regime (BEAC—carmustine, etoposide, cytarabine and cyclophosphamide) for patients with Non-Hodgkin’s Lymphoma (NHL) [2].

Carmustine is an alkylating agent licensed for use in adults with HL and NHL with relapsed or refractory disease [3]. BEAM has been used throughout Europe as standard conditioning for autologous stem cell transplant in HL and NHL.

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Fig. 1: No statistically significant difference in OS shown between BEAM and Leam conditioning.

References

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Acknowledgements

The authors acknowledge the contribution of data from each centre; St George’s Hospital (M Koh, A Drake), Cardiff (K Wilson, D Davies), Christie Hospital Manchester (A Bloor, A Sjursen) Leeds (M Gilleece, R Goodall, C Mountain, H Moss) Southampton (K Orchard, R Lown) Nottingham (N Russell, E Cox) St Bartholomews (J Gribben, D Anderson) Royal Marsden (M Potter, E Nicholson) Edinburgh (A Broom) Newcastle (M Collin, L Duncan) Leicester (M Martin, R Lewin) Brimingham Heartlands (M Nikolousis, M Sharkey) Coventry (F Jones, W Harris-Bailey) Ireland (A Hayat, N Mannion) Derriford/Plymouth (H Hunter, A Whitnall) Poole (F Jack, S Pope) North Staffordshire (S Pillai, K Yarwood) Taunton and Somerset (S Bolam, M Ewings) Cheltenham (S Chown, C Carter) Bournemouth (R Hall, J Davies) Manchester (E Tholouli, E Marchan) Swindon (N Blessing, L Ishmael-Walrond) Dudley (S Fernandes) Bath (C Knetchli, T Peters).

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Authors and Affiliations

  1. Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK

    Philippa Kelsey, John A. Snowden & Nick Morley

  2. British Society of Blood and Marrow Transplantation, London, UK

    Rachel Pearce, Julia Perry, Keiren Kirkland & Ruth Paul

  3. University College London Hospitals NHS Foundation Trust, London, UK

    Jonathan Lambert

  4. Oxford University Hospitals NHS Foundation Trust, Oxford, UK

    Andy Peniket

  5. University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

    Ram Malladi

Authors
  1. Philippa Kelsey
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  2. Rachel Pearce
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  9. John A. Snowden
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Contributions

The Authors contributions were as follows: PK- Wrote the paper. RP- Study statistician. JP- Study co-ordinator. KK- Data manager. RP- Oversaw data collection. JAS- Co-investigator. JL- Contribution of significant patient numbers. NM- Study Chair.

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Correspondence to Philippa Kelsey.

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Kelsey, P., Pearce, R., Perry, J. et al. Substituting carmustine for lomustine is safe and effective in the treatment of relapsed or refractory Lymphoma—a retrospective study from the BSBMT (BEAM versus LEAM). Bone Marrow Transplant 56, 730–732 (2021). https://doi.org/10.1038/s41409-020-01071-2

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