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Busulfan, Melphalan, and Etoposide (Bume) Showed an Equivalent Effect to Busulfan, Cyclophosphamide, and Etoposide (BuCE) as Conditioning Therapy for Autologous Stem Cell Transplantation in Patients with Relapsed or High Risk Non-Hodgkin's Lymphoma: A Multicenter Randomized Phase II Study by the Consortium for Improving Survival of Lymphoma (CISL)

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Author(s)
Kyoung Ha KimJae Hoon LeeMark LeeHoon-Gu KimYoung Rok DoYong ParkSung Yong OhHo-Jin ShinWon Seog KimSung-Kyu ParkJee Hyun KongMoo-Rim ParkDeok-Hwan YangJae-Yong KwakHye Jin KangYeung-Chul MunJong-Ho Won
Keimyung Author(s)
Do, Young Rok
Department
Dept. of Internal Medicine (내과학)
Journal Title
Cancer Res Treat
Issued Date
2023
Volume
55
Issue
1
Keyword
Autologous stem cell transplantationNon-Hodgkin’s lymphomaBusulfan
Abstract
Purpose:
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard management for relapsed or high-risk non-Hodgkin’s lymphoma (NHL). We reported the busulfan/melphalan/etoposide (BuME) conditioning regimen was effective in patients with relapsed or high-risk NHL. Moreover, the busulfan/cyclophosphamide/etoposide (BuCE) conditioning regimen has been used widely in ASCT for NHL. Therefore, based on these encouraging results, this randomized phase II multicenter trial compared the outcomes of BuME and BuCE as conditioning therapies for ASCT in patients with NHL.

Materials and Methods:
Patients were randomly assigned to receive either BuME (n=36) or BuCE (n=39). The BuME regimen was comprised of busulfan (3.2 mg/kg/day, intravenous [i.v.]) administered on Days -7, -6, and -5, etoposide (400 mg/m2 i.v.) on Days -5 and -4, and melphalan (50 mg/m2/day i.v.) on Days- 3 and -2. The BuCE regimen was comprised of busulfan (3.2 mg/kg/day i.v.) on Days -7, -6, and -5, etoposide (400 mg/m2/day i.v.) on Days -5 and -4, and cyclophosphamide (50 mg/kg/day i.v.) on Days -3 and -2. The primary endpoint was 2-year progression-free survival (PFS).

Results:
Seventy-five patients were enrolled. Eleven (30.5%) patients in the BuME group and 13 (33.3%) patients in the BuCE group had disease progression or died. The 2-year PFS rate was 65.4% in the BuME group and 60.6% in the BuCE group (p=0.75). There were no non-relapse mortalities within 100 days after transplantation.

Conclusion:
There were no significant differences in PFS between the two groups. Therefore, busulfan-based conditioning regimens, BuME and BuCE, may be important treatment substitutes for the BCNU-containing regimens.
Keimyung Author(s)(Kor)
도영록
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2005-9256
Source
https://www.e-crt.org/journal/view.php?doi=10.4143/crt.2022.004
DOI
10.4143/crt.2022.004
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44693
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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