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Busulfan, etoposide, cytarabine, and melphalan (BuEAM) as a conditioning regimen for autologous stem cell transplantation in patients with non-Hodgkin lymphoma (NHL)

Bone Marrow Transplantation volume 55, pages 1466–1468 (2020)Cite this article

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BEAM (carmustine (BCNU), etoposide, cytarabine, and melphalan) is a widely used conditioning regimen due to its high efficacy and the experience of physicians in its use. In our previous study, we showed that the survival rates of BEAM are greater than those of BEAC (BCNU, etoposide, cytarabine, and cyclophosphamide) and BEAM has acceptable toxicity rates [1]. However, supply issues of BCNU in Republic of Korea and associated toxicities have emerged; thus, alternative strategies to improve this regimen are required. Busulfan (Bu) is widely used with autologous and allogeneic transplants for various lymphoid malignancies and this has been studied in non-Hodgkin lymphoma (NHL) [2, 3]. Although Bu-containing preparatory regimens are strongly myeloablative; thus, Bu-containing regimens induce higher acute toxicity grades. The Bu-containing regimen and BEAM/BEAC regimens have similar treatment-related mortality (TRM) rates [4]. Therefore, we conducted three prospective studies that replaced BCNU with Bu in the BEAM conditioning regimen. The results of this study may be used to inform the use of busulfan, etoposide, cytarabine, and melphalan (BuEAM) as an alternative to BEAM for the treatment of NHL.

In these prospective, multicenter, observational studies, patients were recruited from seven tertiary hospitals in Republic of Korea. The primary study objective was to evaluate the 3-year progression-free survival (PFS) of an intravenous BuEAM conditioning regimen. Data of the three studies are registered at ClinicalTrials.gov (NCT01063439, NCT01178658, and NCT01178645) and were merged for analysis.

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Acknowledgements

This study received research funds from Korea Otsuka.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea

    Jae-Cheol Jo, Yoo Jin Lee & Yunsuk Choi

  2. Department of Internal Medicine, Severance Hospital, Yeonsei University College of Medicine, Seoul, Korea

    Jin Seok Kim

  3. Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Korea

    Je-Hwan Lee & Jung-Hee Lee

  4. Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine Inje University, Busan, Korea

    Sung-Nam Lim

  5. Department of Hematology and Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea

    Sang Min Lee & Won-Sik Lee

  6. Department of Hematology and Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

    Sung-Soo Yoon & In-Ho Kim

  7. Department of Hematology and Oncology, Daegu Catholic University Hospital, Catholic University of Daegu School of Medicine, Daegu, Korea

    Sung Hwa Bae

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  1. Jae-Cheol Jo
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Correspondence to Sung-Soo Yoon or Won-Sik Lee.

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Jo, JC., Kim, J.S., Lee, JH. et al. Busulfan, etoposide, cytarabine, and melphalan (BuEAM) as a conditioning regimen for autologous stem cell transplantation in patients with non-Hodgkin lymphoma (NHL). Bone Marrow Transplant 55, 1466–1468 (2020). https://doi.org/10.1038/s41409-020-0908-3

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