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Ann Hematol. 2021;100(1):189-196.

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

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제1저자 조재철 · 교신저자 윤성수, 이원식

PMID 33205337 DOI 10.1007/s00277-020-04309-7 IF 2.3 혈액종양내과
소속 (9)
  1. Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
  2. Department of Internal Medicine, Severance Hospital, Yeonsei University College of Medicine, Seoul, Korea.
  3. Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  4. Department of Hematology and Oncology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
  5. Department of Hematology and Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
  6. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. ssysmc@snu.ac.kr.
  7. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  8. Department of Hematology and Oncology, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea.
  9. Department of Hematology and Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. wonsik112@gmail.com.

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.

Keywords

Autologous stem cell transplantationHigh-dose regimenT-cell lymphomas

그 밖의 정보
출판 형태
Clinical Trial, Journal Article, Multicenter Study, Observational Study
저널
Annals of hematology · eISSN 1432-0584
전자 출판
2020-11-17
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 / drug therapy / epidemiology · Male · Melphalan / administration & dosage · Middle Aged · Prospective Studies · Republic of Korea / epidemiology · Transplantation Conditioning / methods · Transplantation, Autologous / methods · Young Adult
Substances
Antineoplastic Agents, Alkylating · Antineoplastic Agents, Phytogenic · Cytarabine · Etoposide · Busulfan · Melphalan
참고문헌
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