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Modified BEAM as conditioning regimen for lymphoma patients undergoing autologous hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 53, pages 91–93 (2018)Cite this article

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Over the last 30 years, BEAM has been the most widely used conditioning regimen before autologous hematopoietic stem cell transplantation (auto-HSCT) for patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) not achieving a CR, relapsing after chemotherapy, or with high-risk disease according to the International Prognostic Index.1, 2, 3 Composed of drugs usually not employed in first-line therapy and not causing high toxicities in older people,4 BEAM is generally very effective and well tolerated. Its most common toxicity consists of early oral and gastrointestinal mucositis, nausea, and vomiting; less frequent are lung, liver, and kidney toxicities.

With the aim of obtaining a higher anti-lymphoma activity and/or reducing the toxic effects, in recent years the BEAM protocol has been modified by replacing Carmustine with Fotemustine5 or high-dose Bendamustine,6 reporting good efficacy and no high, acute, or short-term toxicity profile. Since BEAM requires Ara-C, which some chemotherapy regimens employ at high doses for the treatment of lymphoma,7 we decided not to change the drugs of the BEAM scheme, but to increase the dosage of ARA-C from the standard 200–400 mg/sm/day to 2.000 mg/sm/day, administered in combination with the standard dose of Etoposide over three days instead of four (total ARA-C dose of 6.000 mg/sm) to reduce treatment-related toxicity.

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Acknowledgements

The authors thank AIL Ascoli Piceno ‘Alessandro Troiani’ ONLUS for supporting this study and Federica Liberi for the English revision of the manuscript.

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Authors and Affiliations

  1. Department of Hematology and Stem Cell Transplantation Unit, C. and G. Mazzoni hospital, Ascoli Piceno, Italy

    P Galieni, E Troiani, C Bigazzi, S Mazzotta, M Ruggieri, V Pezzoni, A Dalsass, F Mestichelli, P Caraffa, F Travaglini, S Ferretti, M Angelini, S Angelini & S Falcioni

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  1. P Galieni
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  3. C Bigazzi
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Correspondence to P Galieni.

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Galieni, P., Troiani, E., Bigazzi, C. et al. Modified BEAM as conditioning regimen for lymphoma patients undergoing autologous hematopoietic stem cell transplantation. Bone Marrow Transplant 53, 91–93 (2018). https://doi.org/10.1038/bmt.2017.206

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