Treatment with intravenous busulfan, melphalan, and etoposide followed by autologous stem cell transplantation in patients with non-Hodgkin's lymphoma: a multicenter study from the consortium for improving survival of lymphoma

Kyoung Ha Kim, Won Seog Kim, Seok Jin Kim, Dok Hyun Yoon, Cheolwon Suh, Hye Jin Kang, Chul Won Choi, Ho Sup Lee, Sung Hwa Bae, Jinny Park, Eun Kyung Park, Jae Yong Kwak, Mark Hong Lee, Byung Woog Kang, Sung Kyu Park, Jong Ho Won

Research output: Contribution to journalArticle

Abstract

Several high-dose therapy (HDT) conditioning regimens have been used to treat non-Hodgkin's lymphoma (NHL), such as bis-chloroethylnitrosourea (BCNU)/etoposide/cytosine arabinoside/melphalan (BEAM), BCNU/etoposide/cytosine arabinoside/cyclophosphamide (BEAC), and cyclophosphamide/BCNU/etoposide (CBV). BCNU is an active drug in HDT of NHL, but the supply is limited in some countries, including Korea. Busulfan has been used in allogeneic and autologous stem cell transplantation (ASCT). This phase II study evaluated the efficacy of busulfan/melphalan/etoposide (BuME) as a conditioning regimen for HDT in relapsed or high-risk NHL. The regimen consisted of intravenous busulfan (3.2 mg/kg/day) on days −8, −7, and −6, etoposide (400 mg/m2/day) on days −5 and −4, and melphalan (50 mg/m2/day) on days −3 and −2. A total of 46 patients were included in the study, with 36 (78.3%) achieving a complete response after ASCT. The 2-year progression-free survival (PFS) and overall survival (OS) rates for all patients were 46.7% (95% CI, 31.8–60.4%) and 63.7% (95% CI, 47.7–76.0%), respectively. There was no development of veno-occlusive disease and no treatment-related deaths within 100 days after ASCT. These results indicate that a BuME regimen is well-tolerated and effective for patients with relapsed or high-risk NHL, and may be comparable to some previously used regimens. This regimen may be useful as a substitute for BCNU-containing regimens.

Original languageEnglish
JournalTransplant International
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • autologous stem cell transplantation

ASJC Scopus subject areas

  • Transplantation

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    Kim, K. H., Kim, W. S., Kim, S. J., Yoon, D. H., Suh, C., Kang, H. J., Choi, C. W., Lee, H. S., Bae, S. H., Park, J., Park, E. K., Kwak, J. Y., Lee, M. H., Kang, B. W., Park, S. K., & Won, J. H. (Accepted/In press). Treatment with intravenous busulfan, melphalan, and etoposide followed by autologous stem cell transplantation in patients with non-Hodgkin's lymphoma: a multicenter study from the consortium for improving survival of lymphoma. Transplant International. https://doi.org/10.1111/tri.13664