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Radioimmunotherapy-augmented BEAM chemotherapy vs BEAM alone as the high-dose regimen for autologous stem cell transplantation (ASCT) in relapsed follicular lymphoma (FL): Retrospective study of the EBMT Lymphoma Working Party

Radioimmunotherapy-augmented BEAM chemotherapy vs BEAM alone as the high-dose regimen for autologous stem cell transplantation (ASCT) in relapsed follicular lymphoma (FL): Retrospective study of the EBMT Lymphoma Working Party
Radioimmunotherapy-augmented BEAM chemotherapy vs BEAM alone as the high-dose regimen for autologous stem cell transplantation (ASCT) in relapsed follicular lymphoma (FL): Retrospective study of the EBMT Lymphoma Working Party

Relapse remains the most common cause of treatment failure in patients receiving autologous stem cell transplantation (ASCT) for follicular lymphoma (FL). The aim of this study was to evaluate the effect of adding radioimmunotherapy or rituximab (R) to BEAM (carmustine, etoposide, ara-c, melphalan) high-dose therapy for ASCT in patients with relapsed FL. Using the European Society for Blood and Marrow Transplantation registry, we conducted a cohort comparison of BEAM (n=1973), Zevalin-BEAM (Z-BEAM) (n=207) and R-BEAM (n=179) and also a matched-cohort analysis of BEAM vs Z-BEAM including 282 and 154 patients, respectively. BEAM, Z-BEAM and R-BEAM groups were well balanced for age, time from diagnosis to ASCT and disease status at ASCT. The cumulative incidences of relapse (IR) at 2 years were 34, 34 and 32% for Z-BEAM, R-BEAM and BEAM, respectively. By multivariate analysis, there were no significant differences with Z-BEAM or R-BEAM compared with BEAM for IR, non-relapse mortality, event-free survival or overall survival. With the caveat that the limitations of registry analyses have to be taken into account, this study does not support adding radioimmunotherapy or R to BEAM in ASCT for relapsed FL. However, we cannot rule out the existence a particular subset of patients who could benefit from Z-BEAM conditioning that cannot be identified in our series, and this should be tested in a randomized trial.Bone Marrow Transplantation advance online publication, 22 May 2017; doi:10.1038/bmt.2017.88.

Journal Article
0268-3369
1120-1125
Bento, L.
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Boumendil, A.
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Finel, H.
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Le Gouill, S.
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Amorim, S.
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Monjanel, H.
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Bouabdallah, R
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Bay, J.O.
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Nicolas-Virelizier, E.
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McQuaker, G.
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Huynh, A.
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Malladi, R.
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Orchard, K.
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Bonifazi, F.
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Haenel, A.
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Crawley, C.
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Metzner, B.
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Gribben, J.
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Russell, N.H.
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Damaj, G.
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Thomson, K.
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Bento, L.
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Boumendil, A.
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Finel, H.
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Le Gouill, S.
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Amorim, S.
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Monjanel, H.
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Bouabdallah, R
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Bay, J.O.
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Nicolas-Virelizier, E.
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McQuaker, G.
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Rossi, G.
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Johnson, R.
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Huynh, A.
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Rambaldi, A.
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Bachy, E.
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Malladi, R.
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Orchard, K.
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Pohlreich, D.
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Tilly, H.
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Bonifazi, F.
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Poiré, X.
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Guilhot, F.
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Haenel, A.
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Crawley, C.
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Metzner, B.
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Gribben, J.
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Russell, N.H.
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Damaj, G.
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Thomson, K.
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Dreger, P.
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Montoto, S.
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Bento, L., Boumendil, A., Finel, H., Le Gouill, S., Amorim, S., Monjanel, H., Bouabdallah, R, Bay, J.O., Nicolas-Virelizier, E., McQuaker, G., Rossi, G., Johnson, R., Huynh, A., Ceballos, P., Rambaldi, A., Bachy, E., Malladi, R., Orchard, K., Pohlreich, D., Tilly, H., Bonifazi, F., Poiré, X., Guilhot, F., Haenel, A., Crawley, C., Metzner, B., Gribben, J., Russell, N.H., Damaj, G., Thomson, K., Dreger, P. and Montoto, S. (2017) Radioimmunotherapy-augmented BEAM chemotherapy vs BEAM alone as the high-dose regimen for autologous stem cell transplantation (ASCT) in relapsed follicular lymphoma (FL): Retrospective study of the EBMT Lymphoma Working Party. Bone Marrow Transplantation, 52 (8), 1120-1125. (doi:10.1038/bmt.2017.88).

Record type: Article

Abstract

Relapse remains the most common cause of treatment failure in patients receiving autologous stem cell transplantation (ASCT) for follicular lymphoma (FL). The aim of this study was to evaluate the effect of adding radioimmunotherapy or rituximab (R) to BEAM (carmustine, etoposide, ara-c, melphalan) high-dose therapy for ASCT in patients with relapsed FL. Using the European Society for Blood and Marrow Transplantation registry, we conducted a cohort comparison of BEAM (n=1973), Zevalin-BEAM (Z-BEAM) (n=207) and R-BEAM (n=179) and also a matched-cohort analysis of BEAM vs Z-BEAM including 282 and 154 patients, respectively. BEAM, Z-BEAM and R-BEAM groups were well balanced for age, time from diagnosis to ASCT and disease status at ASCT. The cumulative incidences of relapse (IR) at 2 years were 34, 34 and 32% for Z-BEAM, R-BEAM and BEAM, respectively. By multivariate analysis, there were no significant differences with Z-BEAM or R-BEAM compared with BEAM for IR, non-relapse mortality, event-free survival or overall survival. With the caveat that the limitations of registry analyses have to be taken into account, this study does not support adding radioimmunotherapy or R to BEAM in ASCT for relapsed FL. However, we cannot rule out the existence a particular subset of patients who could benefit from Z-BEAM conditioning that cannot be identified in our series, and this should be tested in a randomized trial.Bone Marrow Transplantation advance online publication, 22 May 2017; doi:10.1038/bmt.2017.88.

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e-pub ahead of print date: 22 May 2017
Published date: 1 August 2017
Keywords: Journal Article

Identifiers

Local EPrints ID: 413729
URI: http://eprints.soton.ac.uk/id/eprint/413729
DOI: doi:10.1038/bmt.2017.88
ISSN: 0268-3369
PURE UUID: bedfcb27-f3aa-40e9-b1c1-58dd9298ad96
ORCID for K. Orchard: ORCID iD orcid.org/0000-0003-2276-3925

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Date deposited: 01 Sep 2017 16:31
Last modified: 16 Mar 2024 05:28

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Contributors

Author: L. Bento
Author: A. Boumendil
Author: H. Finel
Author: S. Le Gouill
Author: S. Amorim
Author: H. Monjanel
Author: R Bouabdallah
Author: J.O. Bay
Author: E. Nicolas-Virelizier
Author: G. McQuaker
Author: G. Rossi
Author: R. Johnson
Author: A. Huynh
Author: P. Ceballos
Author: A. Rambaldi
Author: E. Bachy
Author: R. Malladi
Author: K. Orchard ORCID iD
Author: D. Pohlreich
Author: H. Tilly
Author: F. Bonifazi
Author: X. Poiré
Author: F. Guilhot
Author: A. Haenel
Author: C. Crawley
Author: B. Metzner
Author: J. Gribben
Author: N.H. Russell
Author: G. Damaj
Author: K. Thomson
Author: P. Dreger
Author: S. Montoto

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