High-Dose Ceb Versus Beam With Autologous Stem Cell Transplant In Lymphoma.

Medical records of 72 patients (pts) who underwent high-dose chemo w/auto stem cell transplant (HDC-ASCT) conditioned either CEB (cyclophosphamide 6000 mg/m2, etoposide 2000 mg/m2, carmustine 600 mg/m2) or BEAM (carmustine 300 mg/m2, etoposide 800 mg/m2, cytarabine 1600 mg/m2, melphalan 140 mg/m2) between 1/96 7/02 at an institution. 52 pts received CEB 20 pts received BEAM regimen. Pt characteristics include more males (65%), age >51 years (56%), more NHL (84%) than HD, 63% w/history of complete remission (CR), 33% in CR at time of HDC-ASCT, 54% in partial remission (PR), the remaining pts in stable or relapsed status. Tumor grade in pts w/NHL extranodal involvement were different between the 2 groups (p = 0.02, p = 0.03 respectively). History of prior CR, status prior to ASCT were not significant (p = 0.09, p = 0.09, respectively). Regimen-related toxicities (RRT) examined yielded diarrhea occurring at a different frequency after treatment either CEB or BEAM (p = 0.003). Cases occurred in BEAM group (81%) than in CEB group (51%); pts who received BEAM had milder cases (92%) than CEB (57%). Difference in the incidence of mucositis was not significant (p = 0.12). Pts treated with CEB developed mucositis at a slightly higher rate (79%) than pts treated with BEAM (75%). Mucositis occurred within BEAM group was predominately mild (67%) in contrast to the predominance of moderate to severe cases in CEB group (74%). All pts who required total parenteral nutrition support received CEB regimen. Pts treated w/CEB required growth factor support for longer time than did pts treated w/BEAM (p = 0.04). Four pts (8%) in CEB group 2 pts (11%) in BEAM group developed BCNU pulmonary toxicity, one was hospitalized. Response rate was high in both groups, but no statistical difference was detected (p = 0.09). CEB group, 63% achieved CR 20% achieved PR. BEAM group, 80% achieved CR and 0% achieved PR. Survival was higher after treatment with BEAM (84%) than CEB (60%) (p = 0.09) but wasnt statistically significant. Time to death after HDC-ASCT occurred soon in CEB pts than BEAM pts (p = 0.09) but difference didnt reach statistical sugnificance. Time to disease progression (PD) was different between the 2 treatment groups (p = 0.03). PD occurred frequently in CEB group (38%) than BEAM group (22%) at a faster rate (31% within 6 mo. in CEB group versus 6% in BEAM group). Retrospective analysis, pts conditioned w/BEAM endured less RRT had better survival than pts conditioned w/CEB.