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Busulfan, etoposide, cytarabine, and melphalan as a high-dose regimen for autologous stem cell transplantation in peripheral T-cell lymphomas

Authors
 Jae-Cheol Jo  ;  Jin-Seok Kim  ;  Je-Hwan Lee  ;  Jung-Hee Lee  ;  Seong Nam Im  ;  Sang-Min Lee  ;  Sung-Soo Yoon  ;  In-Ho Kim  ;  Seong Hwa Bae  ;  Yoo Jin Lee  ;  Yunsuk Choi  ;  Won-Sik Lee 
Citation
 ANNALS OF HEMATOLOGY, Vol.100(1) : 189-196, 2021-01 
Journal Title
ANNALS OF HEMATOLOGY
ISSN
 0939-5555 
Issue Date
2021-01
MeSH
Adult ; Aged ; Antineoplastic Agents, Alkylating / administration & dosage ; Antineoplastic Agents, Phytogenic / administration & dosage ; Antineoplastic Combined Chemotherapy Protocols / administration & dosage* ; Busulfan / administration & dosage* ; Cytarabine / administration & dosage* ; Dose-Response Relationship, Drug ; Etoposide / administration & dosage* ; Female ; Hematopoietic Stem Cell Transplantation / methods* ; Humans ; Lymphoma, T-Cell, Peripheral / diagnosis ; Lymphoma, T-Cell, Peripheral / drug therapy* ; Lymphoma, T-Cell, Peripheral / epidemiology ; Male ; Melphalan / administration & dosage* ; Middle Aged ; Prospective Studies ; Republic of Korea / epidemiology ; Transplantation Conditioning / methods ; Transplantation, Autologous / methods ; Young Adult
Keywords
Autologous stem cell transplantation ; High-dose regimen ; T-cell lymphomas
Abstract
Given the unsatisfactory survival in patients who received high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) for peripheral T-cell lymphomas (PTCLs), we conducted a prospective trial of busulfan (Bu), etoposide (E), cytarabine (A), and melphalan (M) (BuEAM), including IV Bu instead of carmustine (BCNU) as in standard BEAM, as a high-dose regimen in such patients. This study evaluated the efficacy and toxicity of BuEAM as a high-dose regimen for ASCT in patients with T-cell lymphomas. The high-dose chemotherapy at seven centers in Korea included Bu (3.2 mg/kg IV qd from day 6 to day 5), E (200 mg/m2 IV bid on day 4 and day 3), A (1 g/m2 IV qd on day 4 and day 3), and M (140 mg/m2 IV qd on day 2). Eighty-one patients were enrolled in this study. The main subtypes were peripheral T-cell lymphoma, not other specified (n = 32, 39.5%), NK/T-cell lymphoma (n = 22, 27.5%), and angioimmunoblastic T-cell lymphoma (n = 12, 14.8%). Upfront and salvage ASCTs were performed in 65 (80.2%) and 16 (19.8%) patients, respectively. The disease status of the patients before ASCT was 54 patients (66.7%) with complete response and 27 patients (33.3%) with partial response. The common grade-III toxicities were anorexia (8.6%), diarrhea (7.4%), and stomatitis (4.9%). No veno-occlusive disorder was noted. Fifty-six (69.1%) and seven (8.6%) patients achieved complete and partial response, respectively, after ASCT, although 17 patients (21.0%) showed progressive disease. At a median follow-up duration of 49.3 months, the estimated 3-year progression-free survival and overall survival were 55.2% and 68.2% in all patients. The BuEAM high-dose regimen for ASCT was well tolerated and seemed to be effective in patients with T-cell lymphomas.
Full Text
https://link.springer.com/article/10.1007/s00277-020-04309-7
DOI
10.1007/s00277-020-04309-7
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191079
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