BEAM Versus Single Agent High Dose Melphalan (HDM) Conditioning Regimen for Autologous Hematopoietic Stem Cell Transplant (ASCT): A Retrospective Matched Analysis in Relapse/Refractory Hodgkin Lymphoma

Hodgkin's lymphoma: Saudi Lymphoma Group's clinical practice guidelines for diagnosis, management and follow-up

“…In most patients with relapsed or refractory HL, the preferred treatment modality comprises platinum-based or brentuximab vedotin-containing regimen followed by high-dose chemotherapy and ASCT (EL-2). [3839404142434445464748] 4.3.3.1 Salvage regimens such as GDP (gemcitabine, dexamethasone, and cisplatin);[49] DICEP (dose-intensive cyclophosphamide, etoposide, cisplatin);[4243] ESHAP (etoposide, methylprednisolone (solumedrol), high-dose cytarabine (ara-C) and cisplatin (platinum chemotherapy);[50] DHAP (dexamethasone, cytarabine, cisplatin);[40] IGEV (ifosfamide, gemcitabine, and vinorelbine);[41] ICE (ifosamide, carboplatin, and etoposide);[51] B-ICE (brentuximab vedotin plus ifosamide, carboplatin, and etoposide;[52] B-ESHAP (brentuximab vedotin plus etoposide, methylprednisolone (solumedrol), high-dose cytarabine (ara-C) and cisplatin (platinum chemotherapy);[53] BeGEV (bendamustine, gemcitabine and vinorelbine) or BvB (Brentuximab vedotin and bendamustine)[5455] have been shown to reduce the disease burden and mobilize stem cells before high-dose chemotherapy and ASCT. However, no comparative trails have shown any salvage approach to be superior than the others (EL-2).4.3.3.2.…”

“…Several conditioning regimes such as BEAM (carmustine, etoposide, cytarabine, melphalan) or single agent high-dose melphalan have also been used (EL-3). [39454647]4.3.3.3. The use of brentuximab vedotin as maintenance therapy for 1 year after ASCT is highly recommended for high-risk patients (primary refractory, patients who relapsed within 12 months, relapse with extra-nodal disease or pre-transplant positive PET/CT) (EL-2).…”

“…In most patients with relapsed or refractory HL, the preferred treatment modality comprises platinum-based or brentuximab vedotin-containing regimen followed by high-dose chemotherapy and ASCT (EL-2). [3839404142434445464748]…”

“…Several conditioning regimes such as BEAM (carmustine, etoposide, cytarabine, melphalan) or single agent high-dose melphalan have also been used (EL-3). [39454647]…”

Saudi lymphoma group's clinical practice guidelines for diagnosis, management and follow-up of patients with various types of lymphoma during the Coronavirus Disease 2019 pandemic

“…If a decision is made to proceed with autologous SCT, high-dose melphalan (Mel200) as conditioning can preferably be used because it is safe, effective and feasible as an outpatient autologous SCT. [ 28 29 ] The use of brentuximab vedotin as maintenance therapy for 1 year after autologous SCT is highly recommended for high-risk patients; however, it might be reasonable to delay starting the maintenance therapy for a few months. [ 30 ] Patients who have confirmed relapse after autologous SCT could be offered other salvage options including immune checkpoint inhibitors (ICIs) such as nivolumab or pembrolizumab, especially as there is no evidence that ICIs are immunosuppressive and avoiding their use in such patients to reduce COVID-19 infections could deprive patients of a highly active class of drugs.…”