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

Abstract

High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (ASCT) is still a consolidation treatment choice for relapsed/refractory 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) conditioning regimen. We retrospectively compared the outcomes of 72 aggressive B-cell NHL patients treated with IEAC or BEAC regimens followed by ASCT as upfront consolidative treatment. 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 (33 and 23 months) were a little longer than that of BEAC group (30 and 18 months). However, due to the small sample numbers, there’s no significant difference in OS and PFS between IEAC and BEAC group with DLBCL or MCL. Multivariate analysis showed that AnnArbor staging, IPI score, lactate dehydrogenase level, remission of disease, modified regimen were related with PFS and OS. In conclusion, IEAC regimen was well tolerated and replacement with idarubicin could be an alternative when carmustine was not available.

Comparison of CEAC, BEAM and IEAC conditioning regimens followed by autologous stem cell transplantation in peripheral T-cell lymphoma patients

“…Although idarubicin is a new anthracycline with high efficacy and low cardiotoxicity compared to daunorubicin, cardiotoxicity remains a significant concern in patients treated with CEAC and IEAC regimens. In this study, grade 3–4 TRAEs were similar to those reported in the published literature 29 , and the TRM rate was only 3.8%. Although 2 patients who received CEAC regimen died of cardiotoxicity, the incidence of cardiotoxicity and TRM rate were not significantly different among the three groups ( P > 0.05).…”

Efficacy of Autologous Hematopoietic Stem Cell Transplantation versus Chemotherapy or Allogeneic Hematopoietic Stem Cell Transplantation for Follicular Lymphoma: Systematic Review and Meta-Analysis

“…BEAM (carmustine, etoposide, cytarabine, and melphalan), CBV (carmustine, cyclophosphamide, and etoposide), and BEAC (carmustine, etoposide, cytarabine, and cyclophosphamide) are commonly used conditioning regimens. Our previous study showed that idarubicin-substituted BEAC (IEAC)-conditioning regimens were well tolerated in patients and had similar OS and PFS as BEAC regimen [28]. However, owing to the limited data provided by the original study, this meta-analysis failed to analyze the heterogeneity caused by the condition regimens.…”