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Bendamustine-EAM versus BEAM regimen in patients with mantle cell lymphoma undergoing autologous stem cell transplantation in the frontline setting: a multicenter retrospective study from Lymphoma Study Association (LYSA) centers

Bone Marrow Transplantation volume 55, pages 1076–1084 (2020)Cite this article

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Abstract

The combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) as conditioning regimen prior to autologous stem-cell transplantation (ASCT) remains the standard of care for patients with mantle cell lymphoma (MCL) who are eligible for transplantation. The replacement of carmustine with bendamustine (BeEAM) was described as a promising alternative in non-Hodgkin lymphoma. The aim of this retrospective study was to compare the BeEAM with the BEAM regimen in MCL patients in the frontline setting. Sixty and 108 patients were included in the BeEAM and the BEAM groups, respectively. At 3 years, progression-free survival (PFS) was significantly higher in the BeEAM than in the BEAM group (84% [73–96] vs. 63% [51–79], p = 0.03). The overall survival was not statistically different between the two groups (p = 0.2). In multivariable analysis, BeEAM regimen remained associated with higher PFS (HR = 0.377, 95% CI, 0.146–0.970; p = 0.043). Subgroup analyses in patients treated with prior rituximab–aracytine induction alone showed that BeEAM improved the PFS compared with BEAM regimen (p = 0.04). Despite the high rate of acute renal failure KDIGO III (32%), treatment-related mortality was not increased with the BeEAM regimen. A prospective randomized trial will be necessary to confirm the beneficial effect of the BeEAM regimen in MCL patients undergoing ASCT.

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Fig. 1: Univariable analysis.
Fig. 2: Subgroup analysis according to induction regimen.
Fig. 3: Subgroup analysis in patients without rituximab maintenance.

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Author information

Authors and Affiliations

  1. Department of Clinical Hematology, Caen University Hospital, F-14000, Caen, France

    Thomas Hueso, Baptiste Delapierre, Sylvain Chantepie & Gandhi Damaj

  2. School of Medicine, Normandy University, F-14000, Caen, France

    Thomas Hueso, Baptiste Delapierre, Sylvain Chantepie & Gandhi Damaj

  3. Department of Clinical Hematology, Nantes University Hospital, Nantes, France

    Thomas Gastinne, Benoît Tessoulin & Steven Le Gouill

  4. CRCINA—Inserm UMR 1232, Nantes University, Nantes, France

    Thomas Gastinne, Benoît Tessoulin & Steven Le Gouill

  5. Department of Clinical Hematology, Paoli Calmettes Institute, Marseille, France

    Sylvain Garciaz & Reda Bouabdallah

  6. Department of Clinical Hematology, Montpellier University Hospital, Montpellier, France

    Emmanuelle Tchernonog

  7. Department of Clinical Hematology, Amiens University Hospital, Amiens, France

    Caroline Delette

  8. Department of Clinical Hematology, François Mitterrand University Hospital, Dijon, France

    René-Olivier Casasnovas

  9. Inserm UMR 1231, Dijon, France

    René-Olivier Casasnovas

  10. Department of Clinical Hematology, Reims University Hospital, Reims, France

    Eric Durot

  11. Department of Clinical Hematology, Rennes University Hospital, F-35033, Rennes, France

    Roch Houot

  12. MICMAC—Inserm UMR 1236, Rennes University, F-35000 Rennes, France

    Roch Houot

  13. Department of Clinical Hematology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France

    Olivier Tournilhac & Richard Lemal

  14. Department of Clinical Hematology, Curie Institute, René Huguenin Hospital, Saint-Cloud, France

    Sandra Malak

  15. Department of Clinical Hematology, Tours University Hospital, Tours, France

    Emmanuel Gyan

  16. Inserm UMR 1415, Tours University, Tours, France

    Emmanuel Gyan

  17. Department of Clinical Hematology, Strasbourg University Hospital, Strasbourg, France

    Luc-Matthieu Fornecker

  18. Department of Clinical Hematology, Limoges University Hospital, Limoges, France

    Julie Abraham

  19. Department of Clinical Hematology, Antoine Lacassagne Center, Nice, France

    Frédéric Peyrade

  20. Department of Clinical Hematology, Grenoble University Hospital, Grenoble, France

    Rémy Gressin

  21. Department of Clinical Hematology, Toulouse Oncopole, Toulouse, France

    Cécile Borel

  22. Department of Biostatistics and Clinical Research, Caen University Hospital, F-14000, Caen, France

    Rémy Morello

  23. Department of Clinical Hematology, Bordeaux University Hospital, France, France

    Krimo Bouabdallah

  24. Department of Clinical Hematology, Makassed General Hospital, Beirut, Libanon, France

    Ahmad Ibrahim

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  1. Thomas Hueso
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TH and GD designed and wrote the paper. TH and RM performed all statistical analyses. All authors reviewed and approved the paper.

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Correspondence to Gandhi Damaj.

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Hueso, T., Gastinne, T., Garciaz, S. et al. Bendamustine-EAM versus BEAM regimen in patients with mantle cell lymphoma undergoing autologous stem cell transplantation in the frontline setting: a multicenter retrospective study from Lymphoma Study Association (LYSA) centers. Bone Marrow Transplant 55, 1076–1084 (2020). https://doi.org/10.1038/s41409-020-0783-y

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