Modified BEAC conditioning regimen with idarubicin followed by autologous hematopoietic stem cell transplantation is safe and effective for invasive B-cell non-Hodgkin’s lymphoma patients

Abstract

High-dose chemotherapy (HDC) followed by autologous hematopoietic stem cell transplantation (ASCT) is still a consolidation treatment choice for relapsed/refractory (R/R) B-cell Non-Hodgkin’s lymphoma (NHL) patients and some aggressive B-cell NHL as frontline therapy. Due to the shortage of carmustine, we switched to idarubicin-substituted BEAC (IEAC). We compared the outcomes of 72 B-cell NHL patients treated with IEAC or BEAC regimens followed by ASCT. The median time to neutrophil and platelet reconstitution showed no difference between IEAC and BEAC groups. IEAC regimen was well tolerated without increase of adverse events. Transplant-related mortality didn’t occur. The overall survival (OS) and progression-free survival (PFS) of IEAC group were a little longer than that of BEAC group. 2-year OS and PFS rate were higher in IEAC group compared to BEAC group. Multivariate analysis showed that AnnArbor staging, IPI score, lactate dehydrogenase (LDH) level, remission of disease, modified regimen were related with the prognosis. In conclusion, IEAC regimen was well tolerated and replacement with idarubicin could effectively prolong the survival of patients.