High dose melphalan is an adequate preparative regimen for autologous hematopoietic stem cell transplantation in relapsed/refractory lymphoma

José A. Fernández-Gutiérrez, Oscar A. Reyes-Cisneros, Mark R. Litzow, Lorena Bojalil-Alvarez, Elizabeth Garcia-Villasenor, Eliezer Tomas Gómez-Gomez, Iván Murrieta-Alvarez, David Gomez-Almaguer, Cesar H. Gutierrez-Aguirre, Amado J. Karduss-Urueta, Guillermo J. Ruiz-Delgado, Guillermo José Ruiz-Arguelles

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: High-dose melphalan (HD-Mel) has been successfully employed in autografting patients with multiple myeloma. An advantage of this regimen is that the total dose of Mel can be delivered in a single day, being particularly useful when non-frozen hematopoietic stem cells are employed in the autograft. Material and Methods: All consecutive patients with R/R lymphomas, both HL and NHL studied and treated at two different centers were prospectively included in a study of ASCT employing a single dose of HD-Mel (200 mg/m2). A group of R/R HL or NHL autografted employing BEAM-like preparative regimens was constructed matched by diagnosis and age. The primary endpoint of the study was overall survival (OS), the secondary endpoint was event-free survival (EFS). Results: Twenty-five R/R HL/NHL patients were prospectively accrued in the study. There were 8 (32%) females, 13 (52%) patients had at least 1 adverse effect: 7 (28%) developed mucositis, 5 (20%) neutropenic fever, and 6 (24%) grade IV nausea. In the HD-Mel group, median overall survival (OS) was not achieved and OS at 36 months was 71%, the transplant-related mortality being 0%. In the control group, median OS was not achieved and the 36-month OS was 76%, results not statistically significant (p 0.5). The EFS was also similar in both groups (p 0.5). Conclusion: HD-Mel alone is non-inferior to a BEAM-like regimen as a preparative regimen for autografting patients with R/R HL and NHL. The regimen is adequate to graft persons with non-frozen stem cells.

Original languageEnglish (US)
Pages (from-to)449-455
Number of pages7
JournalHematology
Volume27
Issue number1
DOIs
StatePublished - 2022

Keywords

  • autologous
  • lymphoma
  • melphalan
  • Relapsed/refractory
  • stem cell transplantation

ASJC Scopus subject areas

  • Hematology

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