본문 바로가기
KERD
논문KCI 등재

Busulfan, Melphalan, and Etoposide (BuME) Showed an Equivalent Effect to Busulfan, Cyclophosphamide, and Etoposide (BuCE) as Conditioning Therapy for Autologous Stem Cell Transplantation in Patients with Relapsed or High-Risk Non-Hodgkin’s Lymphoma: A Multicenter Randomized Phase II Study bythe Consortium for Improving Survival of Lymphoma (CISL)

곽재용|신호진|김원석|강혜진|박성규|문영철|도영록|박용|박무림|원종호|공지현|오성용|김훈구|이재훈|양덕환|김경하|Mark Lee
대한암학회 (Korean Cancer Association)|2023.01|Cancer Research and Treatment|제55권 제1호|pp. 304-313|DOI 10.4143/crt.2022.004

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

Non-Hodgkin’s lymphomaBusulfanAutologous stem cell transplantation
주제분류의학일반

초록

Purpose High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard management for relapsed or high-risk non-Hodgkin’s lymphoma (NHL). We reported the busulfan, melphalan, and etoposide (BuME) conditioning regimen was effective in patients with relapsed or high-risk NHL. Moreover, the busulfan, cyclophosphamide, and etoposide (BuCE) conditioning regimen has been used widely in ASCT for NHL. Therefore, based on these encouraging results, this randomized phase II multicenter trial compared the outcomes of BuME and BuCE as conditioning therapies for ASCT in patients with NHL.Materials and Methods Patients were randomly assigned to receive either BuME (n=36) or BuCE (n=39). The BuME regimen was comprised of busulfan (3.2 mg/kg/day, intravenously) administered on days –7, –6, and –5, etoposide (400 mg/m<sup>2</sup> intravenously) on days –5 and –4, and melphalan (50 mg/m2/day intravenously) on days –3 and –2. The BuCE regimen was comprised of busulfan (3.2 mg/kg/day intravenously) on days –7, –6, and –5, etoposide (400 mg/m<sup>2</sup>/day intravenously) on days –5 and –4, and cyclophosphamide (50 mg/kg/day intravenously) on days –3 and –2. The primary endpoint was 2-year progression-free survival (PFS).Results Seventy-five patients were enrolled. Eleven patients (30.5%) in the BuME group and 13 patients (33.3%) in the BuCE group had disease progression or died. The 2-year PFS rate was 65.4% in the BuME group and 60.6% in the BuCE group (p=0.746). There were no non-relapse mortalities within 100 days after transplantation.Conclusion There were no significant differences in PFS between the two groups. Therefore, busulfan-based conditioning regimens, BuME and BuCE, may be important treatment substitutes for the BCNU-containing regimens.

Abstract

Purpose High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard management for relapsed or high-risk non-Hodgkin’s lymphoma (NHL). We reported the busulfan, melphalan, and etoposide (BuME) conditioning regimen was effective in patients with relapsed or high-risk NHL. Moreover, the busulfan, cyclophosphamide, and etoposide (BuCE) conditioning regimen has been used widely in ASCT for NHL. Therefore, based on these encouraging results, this randomized phase II multicenter trial compared the outcomes of BuME and BuCE as conditioning therapies for ASCT in patients with NHL.Materials and Methods Patients were randomly assigned to receive either BuME (n=36) or BuCE (n=39). The BuME regimen was comprised of busulfan (3.2 mg/kg/day, intravenously) administered on days –7, –6, and –5, etoposide (400 mg/m<sup>2</sup> intravenously) on days –5 and –4, and melphalan (50 mg/m2/day intravenously) on days –3 and –2. The BuCE regimen was comprised of busulfan (3.2 mg/kg/day intravenously) on days –7, –6, and –5, etoposide (400 mg/m<sup>2</sup>/day intravenously) on days –5 and –4, and cyclophosphamide (50 mg/kg/day intravenously) on days –3 and –2. The primary endpoint was 2-year progression-free survival (PFS).Results Seventy-five patients were enrolled. Eleven patients (30.5%) in the BuME group and 13 patients (33.3%) in the BuCE group had disease progression or died. The 2-year PFS rate was 65.4% in the BuME group and 60.6% in the BuCE group (p=0.746). There were no non-relapse mortalities within 100 days after transplantation.Conclusion There were no significant differences in PFS between the two groups. Therefore, busulfan-based conditioning regimens, BuME and BuCE, may be important treatment substitutes for the BCNU-containing regimens.

참고문헌 (27)

  1. Philip T, "Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma", N Engl J Med, 333, pp.1540~1545 (1995)
  2. Mills W, "BEAM chemotherapy and autologous bone marrow transplantation for patients with relapsed or refractory non-Hodgkin’s lymphoma", J Clin Oncol, 13, pp.588~595 (1995)
  3. Salar A, "Autologous stem cell transplantation for clinically aggressive non-Hodgkin’s lymphoma : the role of preparative regimens", Bone Marrow Transplant, 27, pp.405~412 (2001)
  4. Philip T, "Parma international protocol : pilot study of DHAP followed by involved-field radiotherapy and BEAC with autologous bone marrow transplantation", Blood, 77, pp.1587~1592 (1991)
  5. Kim JG, "Multicenter study of intravenous busulfan, cyclophosphamide, and etoposide(i. v. Bu", Cy, Bone Marrow Transplant, pp.2007, 40[DOI]
  6. Isidori A, "Novel regimens prior to autologous stem cell transplantation for the management of adults with relapsed", refractory non-Hodgkin lymphoma and Hodgkin lymphoma : alternatives to BEAM conditioning, 2016, pp.57, 2499~2509
  7. Kuittinen T, "Very acute cardiac toxicity during BEAC chemotherapy in non-Hodgkin’s lymphoma patients undergoing autologous stem cell transplantation", Bone Marrow Transplant, 36, pp.1077~1082 (2005)
  8. Kuittinen T, "Cardiac effects within 3 months of BEAC high-dose therapy in non-Hodgkin’s lymphoma patients undergoing autologous stem cell transplantation", Eur J Haematol, 77, pp.120~127 (2006)
  9. Lemieux C, "Outcome of autologous hematopoietic stem cell transplant in older patients with B cell lymphoma when selected for fitness and chemosensitive disease", Leuk Res, 79, pp.75~80 (2019)
  10. Kim KH, "Treatment with intravenous busulfan, melphalan, and etoposide followed by autologous stem cell transplantation in patients with non-Hodgkin’s lymphoma : a multicenter study from the consortium for improving survival of lymphoma", Transpl Int, 33, pp.1211~1219 (2020)
  11. Bearman SI, "Regimen-related toxicity in patients undergoing bone marrow transplantation", J Clin Oncol, 6, pp.1562~1568 (1988)
  12. Cheson BD, "Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group", J Clin Oncol, 17, pp.1244~ (1999)
  13. Robinson SP, "High-dose therapy with BEAC conditioning compared to BEAM conditioning prior to autologous stem cell transplantation for non-Hodgkin lymphoma : no differences in toxicity or outcome. A matched-control study of the EBMT-Lymphoma Working Party", Bone Marrow Transplant, 53, pp.1553~1559 (2018)
  14. Redondo AM, "Bendamustine as part of conditioning of autologous stem cell transplantation in patients with aggressive lymphoma : a phase 2 study from the GELTAMO group", Br J Haematol, 184, pp.797~807 (2019)
  15. Lee SC, "Excessive toxicity of once daily i. v. BU, melphalan and thiotepa followed by auto SCT on patients with non-Hodgkin’s lymphoma", Bone Marrow Transplant, 45, pp.801~802 (2010)
  16. Avalos BR, "Preparation for marrow transplantation in Hodgkin’s and non-Hodgkin’s lymphoma using Bu", CY, 1993, pp.12, 133~138
  17. Dalle JH, "Hepatic veno-occlusive disease after hematopoietic stem cell transplantation : risk factors and stratification, prophylaxis, and treatment", Biol Blood Marrow Transplant, 22, pp.400~409 (2016)
  18. Copelan EA, "Autotransplantation following busulfan, etoposide and cyclophosphamide in patients with non-Hodgkin’s lymphoma", Bone Marrow Transplant, 25, pp.1243~1248 (2000)
  19. Yanamandra U, "Melphalan-induced cardiotoxicity : ventricular arrhythmias", BMJ Case Rep, 2016, pp.bcr2016218652~ (2016)
  20. Jagadeesh D, "Outcomes of rituximab-BEAM versus BEAM conditioning regimen in patients with diffuse large B cell lymphoma undergoing autologous transplantation", Cancer, 126, pp.2279~2287 (2020)
  21. Vose JM, "Phase III randomized study of rituximab", carmustine, etoposide, cytarabine, and melphalan(BEAM)compared with iodine-131 tositumomab, J Clin Oncol, pp.2013, 31[DOI]
  22. Jo JC, "Busulfan, etoposide, cytarabine, and melphalan as a high-dose regimen for autologous stem cell transplantation in peripheral T-cell lymphomas", Ann Hematol, 100, pp.189~196 (2021)
  23. Park SI, "The role of autologous stem cell transplantation in patients with nodal peripheral T-cell lymphomas in first complete remission : report from COMPLETE, a prospective, multicenter cohort study", Cancer, 125, pp.1507~1517 (2019)
  24. Roerden M, "The role of autologous stem cell transplantation in peripheral T cell lymphoma : a long-term follow-up single-center experience", J Cancer Res Clin Oncol, 145, pp.2595~2604 (2019)
  25. Zahid U, "A review of autologous stem cell transplantation in lymphoma", Curr Hematol Malig Rep, 12, pp.217~226 (2017)
  26. Schuster SJ, "Tisagenlecleucel in adult relapsed or refractory diffuse large B-cell lymphoma", N Engl J Med, 380, pp.45~56 (2019)
  27. Viardot A, "Phase 2 study of the bispecific T-cell engager(BiTE)antibody blinatumomab in relapsed", refractory diffuse large B-cell lymphoma, 2016, pp.127, 1410~1416

관련 논문AI추천

High Dose Chemotherapy and Autologous Stem Cell Transplantation in Non-Hodgkin's Lymphoma: an Eight-Year Experience장현, 정준원, 한지숙연세대학교의과대학 · Yonsei Medical Journal2006 · 제47권 제5호The effect of the dexamethasone, cytarabine, and cisplatin (DHAP) regimen on stem cell mobilization and transplant outcomes of patients with non-Hodgkin’s lymphoma who are candidates for up-front autologous stem cell transplantationDeok-Hwan Yang, Hee Sun Kim, Ho-Young Yhim, Jae-Yong Kwak, Jeong-A Kim, So Yeon Jeon대한내과학회 · The Korean Journal of Internal Medicine2018 · 제33권 제6호Comparison of Total Body Irradiation (TBI) Conditioning with Non-TBI for Autologous Stem Cell Transplantation in Newly Diagnosed or Relapsed Mature T- and NK-Cell Non-Hodgkin Lymphoma강은석, 고영혜, 김석진, 김원석, 맹치훈, 임도훈, 최준영대한암학회 · Cancer Research and Treatment2017 · 제49권 제1호Role of frontline autologous stem cell transplantation in young, high-risk diffuse large B-cell lymphoma patients이석, 김유진, 김종욱, 김희제, 민우성, 민창기, 박장원, 엄기성, 윤재호, 이성은, 이종욱, 전영우, 조석구대한내과학회 · The Korean Journal of Internal Medicine2015 · 제30권 제3호Gemcitabine, Etoposide, Cisplatin, and Dexamethasone in Patients With Refractory or Relapsed Non-Hodgkin’s Lymphoma김기향, 김양수, 손창학, 신성훈, 신호진, 이원식, 정주섭, 조곤재, 주영돈대한내과학회 · The Korean Journal of Internal Medicine2009 · 제24권 제1호Autologous Stem Cell Transplantation using a Modified TAM Conditioning Regimen for Clinically Aggressive Non-Hodgkin’s Lymphoma이종욱, Byoung Yong Shim, Chun Choo Kim, In Sook Woo, Jae Ho Byun, Ji Chan Park, Ji Yean Peak, Myung Ah Lee, Sang Young Rho, Sook Hee Hong, Woo Sung Min, Yoon Ho Koh, Young Seon Hong대한암학회 · Cancer Research and Treatment2007 · 제39권 제2호

이 간행물의 다른 논문 (31건)

Oligometastasis: More Lessons to Be Learned김경환, 안용찬pp. 1-4Top Ten Lessons Learned from Trials in Oligometastatic CancersVivian S. Tan, David A. Palmapp. 5-14Adherence to Cancer Prevention Guidelines and Cancer Incidence and Mortality: A Population-Based Cohort Study박은영, 한민지, 오진경, 김병미pp. 15-27Interlaboratory Comparison Study (Ring Test) of Next-Generation Sequencing–Based NTRK Fusion Detection in South Korea최윤라, 강준, 이승은, 심효섭, 전윤경, 이미숙, 김지훈pp. 28-40Suggestions for Escaping the Dark Ages for Pediatric Diffuse Intrinsic Pontine Glioma Treated with Radiotherapy: Analysis of Prognostic Factors from the National Multicenter Study정재욱, 이주호, 김인아, 김영경, 임정호, 박신형, 김주영, 윤홍인, 서창옥, 안승도, 김일한, 임도훈, 김현주pp. 41-49
원문 보기