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Toxicity Profile According to Etoposide and Cytarabine Dosing in Patients with Lymphoma Receiving Autologous Stem Cell Transplantation Following BEAM Conditioning

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Abstract

High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is part of the treatment strategy for some patients with high-risk lymphoma by improving survival with an acceptable toxicity profile. Although the BEAM (BCNU, etoposide, cytarabine, and melphalan) intensification regimen is the most used, the optimal dosing for each drug is unclear. Here, we retrospectively compared the outcome of 110 patients receiving higher (400 mg/m2, n = 69) or lower (200 mg/m2, n = 41) etoposide and cytarabine doses in our institution between 2012 and 2019. Patients in the BEAM 200 group experienced less toxicity with reduced fever duration (P < 0.001), number of platelet transfusions (P = 0.008), antibiotic duration (P < 0.001), antifungal therapy (P < 0.001), and mucositis (P < 0.001) whereas length of stay, admission to the intensive care unit, and in-hospital mortality were not different between groups. Progression-free survival (PFS) was non-significantly lower in the BEAM 200 group (36-month PFS, 68% vs. 80%, P = 0.053) whereas OS was similar between the two groups (36-month OS, 87% vs. 91%, respectively, P = 0.12). Albeit a non-significant reduction in PFS, BEAM 200 conditioning intensity was associated with a reduced toxicity profile.

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Data availability

The datasets analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank patients and their families for participating in this study.

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Authors and Affiliations

  1. Maladies du Sang, CHU d’Angers, 4 Rue Larrey, 49933, Angers Cedex 9, France

    Agathe Vely, Jérôme Paillassa, Christopher Nunes Gomes, Aurélien Giltat, Marion Klemencie, Aline Clavert, Aline Tanguy-Schmidt, Mathilde Hunault-Berger & Corentin Orvain

  2. Etablissement Français du Sang, Angers, France

    Sophie Fouquet

  3. Département de Pharmacie, CHU d’Angers, Angers, France

    Anne Lebreton

  4. Fédération Hospitalo-Universitaire Grand-Ouest Against Leukemia, FHU-GOAL, Angers, France

    Aline Tanguy-Schmidt, Mathilde Hunault-Berger & Corentin Orvain

  5. Université d’Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCI2NA, F-49000, Angers, France

    Aline Tanguy-Schmidt, Mathilde Hunault-Berger & Corentin Orvain

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  1. Agathe Vely
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  11. Corentin Orvain
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Contributions

AV and CO contributed to the study conception and design; AV collected the data; AV, JP, MHB, and CO prepared the first draft of the manuscript; All authors contributed to the data analysis and to the critical revision. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Corentin Orvain.

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Competing interests

Employment or Leadership Position: none; Consultant or Advisory Role: MHB, Erytech©; Stock Ownership: none; Honoraria: CO, Novartis, MHB, Abbvie, Incyte, and Jazz Pharmaceuticals; Research Funding: none; Expert Testimony: none; Patents: none; Other Remuneration: none.

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Vely, A., Paillassa, J., Nunes Gomes, C. et al. Toxicity Profile According to Etoposide and Cytarabine Dosing in Patients with Lymphoma Receiving Autologous Stem Cell Transplantation Following BEAM Conditioning. Ann Hematol 102, 2225–2231 (2023). https://doi.org/10.1007/s00277-023-05333-z

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  • DOI: https://doi.org/10.1007/s00277-023-05333-z

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