High-dose chemotherapy with BEAM or Busulphan/Melphalan and Thiotepa followed by hematopoietic cell transplantation in malignant lymphoma

We analysed treatment results of two high-dose regimens: BEAM (carmustine, etoposide, cytarabine, melphalan) and BuMelTT (busulphan, melphalan, thiotepa) in autologous transplant patients with non-Hodgkin lymphoma. Patients received BEAM (n=48) or BuMelTT (n=59) from 1998 to 2005. BEAM group patients were older (mean 59.7 vs 50.1 years), more advanced (stageIII 88 vs 61%), had higher IPI/FLIPI scores (score3, 65 vs 19%), and a higher comorbidity index (HCT-CI) (score2, 40 vs 19%). Grade 3-4 complications occurred in 10 patients (17%), with six deaths in the BuMelTT group versus none in the BEAM group. CR was achieved in 20 of 36 (56%) BuMelTT versus 12 of 39 (31%) BEAM patients. After adjusting for IPI/FLIPI, HCT-CI, age and stage of disease, the hazards of death, relapse and treatment failure were similar in both groups. In this retrospective comparison, BEAM regimen appeared to be equally effective but less toxic than BuMelTT.