Fotemustine plus etoposide, cytarabine and melphalan (FEAM) as a new conditioning regimen for lymphoma patients undergoing auto-SCT: a multicenter feasibility study
| Autor: | Renato Scalone, Nicola Cascavilla, P. Di Bartolomeo, Francesco Lanza, Maurizio Musso, Antonello Pinto, Gianpaolo Marcacci, N. Di Renzo, Alessandra Crescimanno, Tania Perrone |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Melphalan Transplantation Conditioning Lymphoma FEAM BEAM Gastroenterology Nitrosourea Compounds fotemustine carmustine conditioning auto-SCT chemistry.chemical_compound Antineoplastic Combined Chemotherapy Protocols Etoposide Graft Survival Cytarabine Hematopoietic Stem Cell Transplantation Hematology Middle Aged Nitrogen mustard Survival Rate Treatment Outcome medicine.drug Adult medicine.medical_specialty Adolescent Transplantation Autologous NO Young Adult Organophosphorus Compounds Internal medicine medicine Mucositis Humans Aged Transplantation business.industry medicine.disease Surgery Kinetics Regimen chemistry Feasibility Studies Fotemustine business |
| Zdroj: | Bone Marrow Transplantation. 45:1147-1153 |
| ISSN: | 1476-5365 0268-3369 |
| Popis: | BEAM is a widely used conditioning regimen for relapsed/refractory lymphoma patients undergoing auto-SCT. We conducted a multicenter study with an alternative regimen (fotemustine plus etoposide, cytarabine and melphalan (FEAM)) in which BCNU was substituted by the chloroethylnitrosourea fotemustine (FTM). Eighty-four patients with relapsed/refractory Hodgkin's (n=20) and non-Hodgkin's lymphoma (n=64) were conditioned with a FEAM regimen (FTM 150 mg/m(2) on days -7, -6, etoposide 200 mg/m(2) and cytarabine 400 mg/m(2) on days -5, -4, -3, -2 and melphalan 140 mg/m(2) on day -1). Patients were evaluated for toxicity and engraftment parameters. Median times to neutrophil (500 x 10(9)/l) and plt (20 000 x 10(9)/l) engraftment were 11 and 13 days, respectively. Grade 3 mucositis occurred in 19 patients (23%), while G3 nausea/vomiting and G3 diarrhea were observed in 13 (15%) and 6 (7%) patients, respectively. No severe hepatic, renal or pulmonary toxicity was detected. Seven patients (7%) experienced G4 mucositis, while no other G4 toxicities or unexpected adverse events of any grade were recorded. Transplant-related mortality was 2.4%. We conclude that a FEAM regimen is feasible and safe. Although toxicity and engraftment times compared favorably with BEAM, longer follow-up is needed to evaluate fully its efficacy and long-term safety. |
| Databáze: | OpenAIRE |
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