Impact of conditioning regimen on outcome of 2-year disease-free survivors of autologous stem cell transplantation for Hodgkin lymphoma

Basem M. William, Fausto R. Loberiza, Victoria Whalen, Philip Jay Bierman, Robert G Bociek, Julie Marie Vose, James Olen Armitage

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24 Citations (Scopus)

Abstract

Background: Autologous stem cell transplantation is the standard of care for patients with relapsed HL and the long-term outcomes for survivors 2 years after ASCT have not been well described. No prospective trials have compared the effect of different conditioning regimens on outcomes. Patients and Methods: We searched the Nebraska Lymphoma Study Group database to identify patients with HL who received ASCT from 1984 to 2007. Patients were conditioned with either CBV (cyclophosphamide, carmustine, and etoposide) or BEAM (carmustine, etoposide, cytarabine, and melphalan). Results: At a median follow-up of 8 (range, 2-26) years, 225 patients were alive and disease-free 2 years after ASCT. Analysis was limited to these patients. At 5 years, the progression-free survival (PFS) was 92% for BEAM and 73% for CBV (P =.002) and the overall survival (OS) was 95% for BEAM and 87% for CBV (P =.07). At 10 years, the PFS was 79% for BEAM and 59% for CBV (P =.01) and the OS was 84% for BEAM and 66% for CBV (P =.02). Conclusion: Patients with HL who are disease-free and alive 2 years after ASCT have favorable outcomes. We observed lower risk of progression and longer survival associated with use of BEAM vs. CBV. Patients in the BEAM group received a transplant in more recent years so we cannot exclude the possibility that the superior outcomes seen in the BEAM group are because of better supportive care, use of peripheral blood stem cell grafts, or improvements in salvage therapies before transplantation.

Original languageEnglish (US)
Pages (from-to)417-423
Number of pages7
JournalClinical Lymphoma, Myeloma and Leukemia
Volume13
Issue number4
DOIs
StatePublished - Aug 1 2013

Fingerprint

Stem Cell Transplantation
Hodgkin Disease
Survivors
Carmustine
Etoposide
Disease-Free Survival
Survival
Transplants
Salvage Therapy
Melphalan
Cytarabine
Standard of Care
Cyclophosphamide
Lymphoma
Transplantation
Databases

Keywords

  • BEAM
  • CBV
  • Carmustine
  • Chemosensitivity
  • Hematopoietic transplantation
  • High-dose chemotherapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

@article{ce3a15677918475c8ba2bdec00b5611a,
title = "Impact of conditioning regimen on outcome of 2-year disease-free survivors of autologous stem cell transplantation for Hodgkin lymphoma",
abstract = "Background: Autologous stem cell transplantation is the standard of care for patients with relapsed HL and the long-term outcomes for survivors 2 years after ASCT have not been well described. No prospective trials have compared the effect of different conditioning regimens on outcomes. Patients and Methods: We searched the Nebraska Lymphoma Study Group database to identify patients with HL who received ASCT from 1984 to 2007. Patients were conditioned with either CBV (cyclophosphamide, carmustine, and etoposide) or BEAM (carmustine, etoposide, cytarabine, and melphalan). Results: At a median follow-up of 8 (range, 2-26) years, 225 patients were alive and disease-free 2 years after ASCT. Analysis was limited to these patients. At 5 years, the progression-free survival (PFS) was 92{\%} for BEAM and 73{\%} for CBV (P =.002) and the overall survival (OS) was 95{\%} for BEAM and 87{\%} for CBV (P =.07). At 10 years, the PFS was 79{\%} for BEAM and 59{\%} for CBV (P =.01) and the OS was 84{\%} for BEAM and 66{\%} for CBV (P =.02). Conclusion: Patients with HL who are disease-free and alive 2 years after ASCT have favorable outcomes. We observed lower risk of progression and longer survival associated with use of BEAM vs. CBV. Patients in the BEAM group received a transplant in more recent years so we cannot exclude the possibility that the superior outcomes seen in the BEAM group are because of better supportive care, use of peripheral blood stem cell grafts, or improvements in salvage therapies before transplantation.",
keywords = "BEAM, CBV, Carmustine, Chemosensitivity, Hematopoietic transplantation, High-dose chemotherapy",
author = "William, {Basem M.} and Loberiza, {Fausto R.} and Victoria Whalen and Bierman, {Philip Jay} and Bociek, {Robert G} and Vose, {Julie Marie} and Armitage, {James Olen}",
year = "2013",
month = "8",
day = "1",
doi = "10.1016/j.clml.2013.03.009",
language = "English (US)",
volume = "13",
pages = "417--423",
journal = "Clinical Lymphoma, Myeloma and Leukemia",
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TY - JOUR

T1 - Impact of conditioning regimen on outcome of 2-year disease-free survivors of autologous stem cell transplantation for Hodgkin lymphoma

AU - William, Basem M.

AU - Loberiza, Fausto R.

AU - Whalen, Victoria

AU - Bierman, Philip Jay

AU - Bociek, Robert G

AU - Vose, Julie Marie

AU - Armitage, James Olen

PY - 2013/8/1

Y1 - 2013/8/1

N2 - Background: Autologous stem cell transplantation is the standard of care for patients with relapsed HL and the long-term outcomes for survivors 2 years after ASCT have not been well described. No prospective trials have compared the effect of different conditioning regimens on outcomes. Patients and Methods: We searched the Nebraska Lymphoma Study Group database to identify patients with HL who received ASCT from 1984 to 2007. Patients were conditioned with either CBV (cyclophosphamide, carmustine, and etoposide) or BEAM (carmustine, etoposide, cytarabine, and melphalan). Results: At a median follow-up of 8 (range, 2-26) years, 225 patients were alive and disease-free 2 years after ASCT. Analysis was limited to these patients. At 5 years, the progression-free survival (PFS) was 92% for BEAM and 73% for CBV (P =.002) and the overall survival (OS) was 95% for BEAM and 87% for CBV (P =.07). At 10 years, the PFS was 79% for BEAM and 59% for CBV (P =.01) and the OS was 84% for BEAM and 66% for CBV (P =.02). Conclusion: Patients with HL who are disease-free and alive 2 years after ASCT have favorable outcomes. We observed lower risk of progression and longer survival associated with use of BEAM vs. CBV. Patients in the BEAM group received a transplant in more recent years so we cannot exclude the possibility that the superior outcomes seen in the BEAM group are because of better supportive care, use of peripheral blood stem cell grafts, or improvements in salvage therapies before transplantation.

AB - Background: Autologous stem cell transplantation is the standard of care for patients with relapsed HL and the long-term outcomes for survivors 2 years after ASCT have not been well described. No prospective trials have compared the effect of different conditioning regimens on outcomes. Patients and Methods: We searched the Nebraska Lymphoma Study Group database to identify patients with HL who received ASCT from 1984 to 2007. Patients were conditioned with either CBV (cyclophosphamide, carmustine, and etoposide) or BEAM (carmustine, etoposide, cytarabine, and melphalan). Results: At a median follow-up of 8 (range, 2-26) years, 225 patients were alive and disease-free 2 years after ASCT. Analysis was limited to these patients. At 5 years, the progression-free survival (PFS) was 92% for BEAM and 73% for CBV (P =.002) and the overall survival (OS) was 95% for BEAM and 87% for CBV (P =.07). At 10 years, the PFS was 79% for BEAM and 59% for CBV (P =.01) and the OS was 84% for BEAM and 66% for CBV (P =.02). Conclusion: Patients with HL who are disease-free and alive 2 years after ASCT have favorable outcomes. We observed lower risk of progression and longer survival associated with use of BEAM vs. CBV. Patients in the BEAM group received a transplant in more recent years so we cannot exclude the possibility that the superior outcomes seen in the BEAM group are because of better supportive care, use of peripheral blood stem cell grafts, or improvements in salvage therapies before transplantation.

KW - BEAM

KW - CBV

KW - Carmustine

KW - Chemosensitivity

KW - Hematopoietic transplantation

KW - High-dose chemotherapy

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U2 - 10.1016/j.clml.2013.03.009

DO - 10.1016/j.clml.2013.03.009

M3 - Article

C2 - 23773453

AN - SCOPUS:84880710848

VL - 13

SP - 417

EP - 423

JO - Clinical Lymphoma, Myeloma and Leukemia

JF - Clinical Lymphoma, Myeloma and Leukemia

SN - 2152-2669

IS - 4

ER -