Retrospective evaluation of the MEAM regimen as a conditioning regimen before autologous peripheral blood stem cell transplantation for lymphoma in two centers with different dosing schedules of melphalan
The BEAM regimen consisting of carmustine (BCNU), etoposide, cytarabine, and melphalan (MEL) is widely used before autologous hematopoietic stem cell transplantation (auto-HSCT) for lymphoma. However, intravenous BCNU is not available in Japan, and therefore, ranimustine (MCNU) has been used instead...
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| Veröffentlicht in: | Annals of hematology 2016-09, Vol.95 (9), p.1513-1519 |
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| creator | Sugimoto, Miyuki Ito, Shoko Mashima, Kiyomi Umino, Kento Minakata, Daisuke Nakano, Hirofumi Yamasaki, Ryoko Kawasaki, Yasufumi Ashizawa, Masahiro Yamamoto, Chihiro Fujiwara, Shin-ichiro Okazuka, Kiyoshi Hatano, Kaoru Sato, Kazuya Oh, Iekuni Ohmine, Ken Suzuki, Takahiro Muroi, Kazuo Kako, Shinichi Kanda, Yoshinobu |
| description | The BEAM regimen consisting of carmustine (BCNU), etoposide, cytarabine, and melphalan (MEL) is widely used before autologous hematopoietic stem cell transplantation (auto-HSCT) for lymphoma. However, intravenous BCNU is not available in Japan, and therefore, ranimustine (MCNU) has been used instead of BCNU (the MEAM regimen). We retrospectively analyzed the outcome of 79 adult patients who underwent auto-HSCT for lymphoma using this regimen in two centers, with 1- and 2-day dosing of MEL, respectively. Three-year overall survival (OS) and progression-free survival (PFS) probabilities were 77.3 and 56.5 % in the entire population and 71.7 and 58.0 % in patients with diffuse large B cell lymphoma. These outcomes were at least equivalent to those with the BEAM regimen. There was no regimen-related pulmonary toxicity. In a multivariate analysis, older age was the only factor that was significantly associated with for OS. In a comparison of the two MEL dosing schedules, while there was no significant differences in either OS or PFS, diarrhea was observed more frequently with 1-day dosing of MEL. In conclusion, the MEAM regimen appeared to be a promising conditioning regimen in auto-HSCT for lymphoma. A large prospective study is warranted to confirm the current findings. |
| doi_str_mv | 10.1007/s00277-016-2740-9 |
| format | Article |
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However, intravenous BCNU is not available in Japan, and therefore, ranimustine (MCNU) has been used instead of BCNU (the MEAM regimen). We retrospectively analyzed the outcome of 79 adult patients who underwent auto-HSCT for lymphoma using this regimen in two centers, with 1- and 2-day dosing of MEL, respectively. Three-year overall survival (OS) and progression-free survival (PFS) probabilities were 77.3 and 56.5 % in the entire population and 71.7 and 58.0 % in patients with diffuse large B cell lymphoma. These outcomes were at least equivalent to those with the BEAM regimen. There was no regimen-related pulmonary toxicity. In a multivariate analysis, older age was the only factor that was significantly associated with for OS. In a comparison of the two MEL dosing schedules, while there was no significant differences in either OS or PFS, diarrhea was observed more frequently with 1-day dosing of MEL. In conclusion, the MEAM regimen appeared to be a promising conditioning regimen in auto-HSCT for lymphoma. A large prospective study is warranted to confirm the current findings.</description><identifier>ISSN: 0939-5555</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-016-2740-9</identifier><identifier>PMID: 27365141</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Cytarabine - administration & dosage ; Cytarabine - adverse effects ; Disease-Free Survival ; Dose-Response Relationship, Drug ; Etoposide - administration & dosage ; Etoposide - adverse effects ; Febrile Neutropenia - chemically induced ; Female ; Hematology ; Humans ; Lymphoma - classification ; Lymphoma - therapy ; Male ; Medicine ; Medicine & Public Health ; Melphalan - administration & dosage ; Melphalan - adverse effects ; Middle Aged ; Nausea - chemically induced ; Nitrosourea Compounds - administration & dosage ; Nitrosourea Compounds - adverse effects ; Oncology ; Original Article ; Peripheral Blood Stem Cell Transplantation - methods ; Retrospective Studies ; Transplantation Conditioning - adverse effects ; Transplantation Conditioning - methods ; Transplantation, Autologous ; Treatment Outcome ; Young Adult</subject><ispartof>Annals of hematology, 2016-09, Vol.95 (9), p.1513-1519</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-bee818a692a1e138c13d8ecb91e280b301224af40329f806b1fa06f72d72b89d3</citedby><cites>FETCH-LOGICAL-c372t-bee818a692a1e138c13d8ecb91e280b301224af40329f806b1fa06f72d72b89d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00277-016-2740-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00277-016-2740-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27365141$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sugimoto, Miyuki</creatorcontrib><creatorcontrib>Ito, Shoko</creatorcontrib><creatorcontrib>Mashima, Kiyomi</creatorcontrib><creatorcontrib>Umino, Kento</creatorcontrib><creatorcontrib>Minakata, Daisuke</creatorcontrib><creatorcontrib>Nakano, Hirofumi</creatorcontrib><creatorcontrib>Yamasaki, Ryoko</creatorcontrib><creatorcontrib>Kawasaki, Yasufumi</creatorcontrib><creatorcontrib>Ashizawa, Masahiro</creatorcontrib><creatorcontrib>Yamamoto, Chihiro</creatorcontrib><creatorcontrib>Fujiwara, Shin-ichiro</creatorcontrib><creatorcontrib>Okazuka, Kiyoshi</creatorcontrib><creatorcontrib>Hatano, Kaoru</creatorcontrib><creatorcontrib>Sato, Kazuya</creatorcontrib><creatorcontrib>Oh, Iekuni</creatorcontrib><creatorcontrib>Ohmine, Ken</creatorcontrib><creatorcontrib>Suzuki, Takahiro</creatorcontrib><creatorcontrib>Muroi, Kazuo</creatorcontrib><creatorcontrib>Kako, Shinichi</creatorcontrib><creatorcontrib>Kanda, Yoshinobu</creatorcontrib><title>Retrospective evaluation of the MEAM regimen as a conditioning regimen before autologous peripheral blood stem cell transplantation for lymphoma in two centers with different dosing schedules of melphalan</title><title>Annals of hematology</title><addtitle>Ann Hematol</addtitle><addtitle>Ann Hematol</addtitle><description>The BEAM regimen consisting of carmustine (BCNU), etoposide, cytarabine, and melphalan (MEL) is widely used before autologous hematopoietic stem cell transplantation (auto-HSCT) for lymphoma. However, intravenous BCNU is not available in Japan, and therefore, ranimustine (MCNU) has been used instead of BCNU (the MEAM regimen). We retrospectively analyzed the outcome of 79 adult patients who underwent auto-HSCT for lymphoma using this regimen in two centers, with 1- and 2-day dosing of MEL, respectively. Three-year overall survival (OS) and progression-free survival (PFS) probabilities were 77.3 and 56.5 % in the entire population and 71.7 and 58.0 % in patients with diffuse large B cell lymphoma. These outcomes were at least equivalent to those with the BEAM regimen. There was no regimen-related pulmonary toxicity. In a multivariate analysis, older age was the only factor that was significantly associated with for OS. In a comparison of the two MEL dosing schedules, while there was no significant differences in either OS or PFS, diarrhea was observed more frequently with 1-day dosing of MEL. In conclusion, the MEAM regimen appeared to be a promising conditioning regimen in auto-HSCT for lymphoma. A large prospective study is warranted to confirm the current findings.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Cytarabine - administration & dosage</subject><subject>Cytarabine - adverse effects</subject><subject>Disease-Free Survival</subject><subject>Dose-Response Relationship, Drug</subject><subject>Etoposide - administration & dosage</subject><subject>Etoposide - adverse effects</subject><subject>Febrile Neutropenia - chemically induced</subject><subject>Female</subject><subject>Hematology</subject><subject>Humans</subject><subject>Lymphoma - classification</subject><subject>Lymphoma - therapy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Melphalan - administration & dosage</subject><subject>Melphalan - adverse effects</subject><subject>Middle Aged</subject><subject>Nausea - chemically induced</subject><subject>Nitrosourea Compounds - administration & dosage</subject><subject>Nitrosourea Compounds - adverse effects</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Peripheral Blood Stem Cell Transplantation - methods</subject><subject>Retrospective Studies</subject><subject>Transplantation Conditioning - adverse effects</subject><subject>Transplantation Conditioning - methods</subject><subject>Transplantation, Autologous</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0939-5555</issn><issn>1432-0584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kc1u1TAQhS0EopfCA7BBI7EO2E5u7CyrqvxIrZAQrCMnHt-4cuxgO636jjwUjlIqNnhjyfOdc6w5hLxl9AOjVHxMlHIhKsraiouGVt0zcmBNzSt6lM1zcqBd3VXHcs7Iq5RuKWVcNvwlOeOibo-sYQfy-zvmGNKCY7Z3CHin3KqyDR6CgTwh3Fxd3EDEk53Rg0qgYAxe2w2x_vQ0GdCEiKDWHFw4hTXBgtEuE0blYHAhaEgZZxjROchR-bQ45fMeVaTgHuZlCrMC6yHfhwL6jDHBvc0TaGsMxvICOqQtNo0T6tVh2r45o1smVexekxdGuYRvHu9z8vPT1Y_LL9X1t89fLy-uq7EWPFcDomRStR1XDFktR1ZriePQMeSSDnVZE2-UaWjNOyNpOzCjaGsE14IPstP1OXm_-y4x_Fox5f42rNGXyJ5JRjvRSiELxXZqLAtOEU2_RDur-NAz2m_99Xt_femv3_rru6J59-i8DjPqJ8XfwgrAdyCVkT9h_Cf6v65_AN0hqzU</recordid><startdate>20160901</startdate><enddate>20160901</enddate><creator>Sugimoto, Miyuki</creator><creator>Ito, Shoko</creator><creator>Mashima, Kiyomi</creator><creator>Umino, Kento</creator><creator>Minakata, Daisuke</creator><creator>Nakano, Hirofumi</creator><creator>Yamasaki, Ryoko</creator><creator>Kawasaki, Yasufumi</creator><creator>Ashizawa, Masahiro</creator><creator>Yamamoto, Chihiro</creator><creator>Fujiwara, Shin-ichiro</creator><creator>Okazuka, Kiyoshi</creator><creator>Hatano, Kaoru</creator><creator>Sato, Kazuya</creator><creator>Oh, Iekuni</creator><creator>Ohmine, Ken</creator><creator>Suzuki, Takahiro</creator><creator>Muroi, Kazuo</creator><creator>Kako, Shinichi</creator><creator>Kanda, Yoshinobu</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20160901</creationdate><title>Retrospective evaluation of the MEAM regimen as a conditioning regimen before autologous peripheral blood stem cell transplantation for lymphoma in two centers with different dosing schedules of melphalan</title><author>Sugimoto, Miyuki ; Ito, Shoko ; Mashima, Kiyomi ; Umino, Kento ; Minakata, Daisuke ; Nakano, Hirofumi ; Yamasaki, Ryoko ; Kawasaki, Yasufumi ; Ashizawa, Masahiro ; Yamamoto, Chihiro ; Fujiwara, Shin-ichiro ; Okazuka, Kiyoshi ; Hatano, Kaoru ; Sato, Kazuya ; Oh, Iekuni ; Ohmine, Ken ; Suzuki, Takahiro ; Muroi, Kazuo ; Kako, Shinichi ; Kanda, Yoshinobu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-bee818a692a1e138c13d8ecb91e280b301224af40329f806b1fa06f72d72b89d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - 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However, intravenous BCNU is not available in Japan, and therefore, ranimustine (MCNU) has been used instead of BCNU (the MEAM regimen). We retrospectively analyzed the outcome of 79 adult patients who underwent auto-HSCT for lymphoma using this regimen in two centers, with 1- and 2-day dosing of MEL, respectively. Three-year overall survival (OS) and progression-free survival (PFS) probabilities were 77.3 and 56.5 % in the entire population and 71.7 and 58.0 % in patients with diffuse large B cell lymphoma. These outcomes were at least equivalent to those with the BEAM regimen. There was no regimen-related pulmonary toxicity. In a multivariate analysis, older age was the only factor that was significantly associated with for OS. In a comparison of the two MEL dosing schedules, while there was no significant differences in either OS or PFS, diarrhea was observed more frequently with 1-day dosing of MEL. In conclusion, the MEAM regimen appeared to be a promising conditioning regimen in auto-HSCT for lymphoma. A large prospective study is warranted to confirm the current findings.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27365141</pmid><doi>10.1007/s00277-016-2740-9</doi><tpages>7</tpages></addata></record> |
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| ispartof | Annals of hematology, 2016-09, Vol.95 (9), p.1513-1519 |
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| subjects | Adolescent Adult Aged Antineoplastic Combined Chemotherapy Protocols - adverse effects Antineoplastic Combined Chemotherapy Protocols - therapeutic use Cytarabine - administration & dosage Cytarabine - adverse effects Disease-Free Survival Dose-Response Relationship, Drug Etoposide - administration & dosage Etoposide - adverse effects Febrile Neutropenia - chemically induced Female Hematology Humans Lymphoma - classification Lymphoma - therapy Male Medicine Medicine & Public Health Melphalan - administration & dosage Melphalan - adverse effects Middle Aged Nausea - chemically induced Nitrosourea Compounds - administration & dosage Nitrosourea Compounds - adverse effects Oncology Original Article Peripheral Blood Stem Cell Transplantation - methods Retrospective Studies Transplantation Conditioning - adverse effects Transplantation Conditioning - methods Transplantation, Autologous Treatment Outcome Young Adult |
| title | Retrospective evaluation of the MEAM regimen as a conditioning regimen before autologous peripheral blood stem cell transplantation for lymphoma in two centers with different dosing schedules of melphalan |
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