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Bendamustine Combo Regimen May Benefit Patients With MCL Eligible for ASCT
A treatment regimen combining bendamustine with etoposide, cytarabine, and melphalan (BeEAM) for conditioning before autologous stem-cell transplantation (ASCT) in patients with mantle cell lymphoma (MCL) eligible for transplantation did not lead to increased therapy-related mortality, findings from a retrospective study show (Bone Marrow Transplant. 2020 Jan 17. Epub ahead of print).
“The combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) as conditioning regimen prior to…ASCT…remains the standard of care for patients with…MCL…who are eligible for transplantation,” said Thomas Hueso, MD, PhD, Department of Clinical Hematology, Caen University Hospital, France, and colleagues.
Because bendamustine has been described as a promising alternative to carmustine in patients with non-Hodgkin lymphoma receiving BEAM, Dr Hueso sought to compare frontline BeEAM with BEAM in 168 patients with MCL. A total of 60 patients received BeEAM therapy, whereas the remaining 108 received BEAM.
Ultimately, the 3-year progression-free survival (PFS) rate was significantly higher with BeEAM versus BEAM (84% vs 63%, respectively; P = .03).
Although there was no statistical difference in overall survival between the 2 arms (P = .2), multivariable analysis revealed that the BeEAM regimen was consistently tied to higher PFS (hazard ratio, 0.377; 95% CI, 0.146-0.970; P = .043).
Subgroup analyses in patients treated with prior rituximab–aracytine induction alone showed that BeEAM improved the PFS compared with BEAM regimen (P = .04).
“Despite the high rate of acute renal failure KDIGO III (32%), treatment-related mortality was not increased with the BeEAM regimen,” Dr Hueso and co-investigators reported.
“A prospective randomized trial will be necessary to confirm the beneficial effect of the BeEAM regimen in MCL patients undergoing ASCT,” they said.—Hina Porcelli
