Single-center retrospective study assessing the efficacy and safety of BeEAM (bendamustine, etoposide, cytarabine, melphalan) as conditioning regimen for autologous hematopoietic stem cell transplantation

Figures & data

Table 1. Inclusion and exclusion criteria.

Inclusion criteria	Exclusion criteria
Age > 18 years Lymphoma requiring auto-HSCT: Refractory HL Refractory DLBCL Refractory Follicular Lymphoma (POD24) Mantle cell lymphoma Data available in patient’s file	T cell Lymphoma (BEAM) Central nervous system Lymphoma (BCNU + thiotepa) Patient having benefited from autoHSCT with any other conditioning regimen than Benda-EAM

Table 2. Patient characteristics.

Median age, (difference)	59 (17-72)
Sex (Men/Women)	35/20
Basic performance status (ECOG), n (%)
0-1	51 (93%)
2	4 (7%)
3	0
4	0
Histological classification, n (%)
DLCBL	26 (47%)
HL	14 (25%)
Follicular NHL	1 (2%)
Mantle cell NHL	14 (25%)
Classification of Lugano
Stage I	2 (4%)
Stage II	11 (20%)
Stage III	8 (15%)
Stage IV	33 (69%)
Indeterminate	1 (2%)
B-symptoms	23 (42%)
Bone Marrow involvement
Yes	14 (26%)
No	40 (73%)
Undetermined	1 (2%)
Extranodal involvement ≥ 1	39 (71%)
Bulky Disease	18 (33%)
Lactate dehydrogenase
High	28 (51%)
Normal	21 (38%)
Undetermined	6 (11%)
B2-microglobulin
High	1 (2%)
Normal	6 (11%)
Undetermined	48 (87%)
IPI Score (DLCBL)
0-1	11 (20%)
2	19 (34%)
3	18 (33%)
4	6 (11%)
Undetermined	1 (2%)

Figure 1. Progression-free survival.

Figure 2. Progression-free survival according to histological status.

Figure 3. Overall survival.

Figure 4. Overall survival according to histological status.

Table 3. Infectious adverse events.

	Grade 1	Grade 2	Grade 3	Grade 4	Grade 5	%
Febrile neutropenia			46	7	1	98%
Invasive Aspergillosis			1			2%
Covid 19			1			2%
Candidemia				1	1	4%
Oesophagitis			5			9%
Enteritis/Colitis/Rectitis			26	6	1	60%
Typhlitis				1		2%
Mucositis		3	35			73%
Pneumoniae			7			13%
Tinea cruris			1			2%
Urinary tract infection			6			11%
Labial Herpes			3			6%
Catheter bloodstream infection			3			5%
Folliculitis			2			4%
Cellulitis			1			2%

Table 4. Identified pathogens during febrile neutropenia.

Pathogens
E. Coli	6 (21%)
C. Difficile	9 (31%)
Candida	8 (28%)
Klebsiella pneumonia	3 (10%)
Staphylococcus haemolyticus	1 (3%)
Covid 19	1 (3%)
Aspergillosis	1 (3%)
Streptococcus mitis	1 (3%)
Enterococcus faecalis	1 (3%)
Proteus mirabilis	1 (3%)
Pseudomonas	2 (7%)
H. Influenzae	1 (3%)
Campylobacter jejuni	1 (3%)
Streptococcus epidermidis	1 (3%)
Influenzae A	1 (3%)
HSV	2 (7%)
Tinea cruris	1 (3%)

Table 6. Noninfectious adverse events.

	Grade 1	Grade 2	Grade 3	Grade 4	Grade 5	%
Renal failure	9	6	3	1		19%
Deep venous thrombosis			2		1	5%
Pulmonary embolism				2	1	5%
Atrial fibrillation			2	2	1	9%
Upper/lower gastrointestinal bleeding			2	1	1	7%
Adrenal insufficiency			2	1	1	7%%
Delirium		2			1	5%
Hepatic cytolysis	6		1			13%
Hyperbilirubinemia		1				2%
Toe necrosis			1			2%
NSTEMI		1				2%
Refractory Thrombocytopenia			2		1	5%
Nausea		1	3			7%
Seizure			1			2%
Cardiac Overload			4			7%
Diarrhea		5	2			13%
Hematuria		1		1		4%
Diabetes insipidus			2			4%
Intestinal pseudo-obstruction				1		2%
Epistaxis		3				5%
Hyperthyroidism		1				2%
Catheter air embolism				1		2%
Suicidal ideation			1			2%

Table 5. Specific treatment, TRM and readmission rate.

Blood product	51 (93%)
Parenteral nutrition	39 (71%)
Continuous veno-venous Hemofiltration	3 (5%)
Readmission	6 (11%)
TRM	2 (4%)

Table 7. Reduce dose BeEAM conditioning regimen.

Hodgkin Lymphoma	>55 years	BEAM or BeEAM (Bendamustine 100-120mg/m^2)
	<55 years without comorbidity	BeEAM (Bendamustine 180-200mg/m^2)
DLBCL	>55 years	BEAM or BeEAM (Bendamustine 100-120mg/m^2)
	<55 years without comorbidity	BeEAM (Bendamustine 180-200mg/m^2)
	Preceding allo-BMT	BeEAM (Bendamustine 100mg/m^2)
MC Lymphoma	BeEAM 100mg/m^2
	Consider BEAM over 60 years