Mini-BEAM as salvage therapy for relapsed or refractory Hodgkin's disease before intensive therapy and autologous bone marrow transplantation

Richard Colwill, Michael Crump, Felix Couture, Rizwan Danish, A. Keith Stewart, David M.C. Sutton, J. Gerald Scott, Simon B. Sutcliffe, Joseph M. Brandwein, Armand Keating

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87 Scopus citations

Abstract

Purpose: To evaluate the efficacy of carmustine (BCNU), etoposide, cytarabine (Ara-C), and melphalan (mini-BEAM) as salvage therapy in patients with relapsed or refractory Hodgkin's disease who were potentially eligible to undergo intensive therapy and autologous bone marrow transplantation (ABMT). Patients and Methods: Forty-four patients with refractory or relapsed Hodgkin's disease after front-line combination chemotherapy referred for consideration of ABMT were treated with mini-BEAM (BCNU 60 mg/m2 on day 1, etoposide 75 mg/m2 on days 2 to 5, Ara-C 100 mg/m2 twice per day on days 2 to 5, and melphalan 30 mg/m2 on day 6) to maximum response. Eleven patients were refractory to primary chemotherapy. Twenty-three patients were treated in first relapse and 10 in second or subsequent relapse; 21 received mini- BEAM as their first salvage regimen. Patients were restaged to determine disease status immediately before intensive therapy and transplant. Results: The overall response rate was 84% (exact 95% confidence interval [CI], 70% to 92%), with a complete response (CR) rate of 32% (95% CI, 20% to 47%) and a partial response (PR) rate of 52%. No treatment-related deaths were observed. Myelosuppression was the major toxicity. Almost all patients required platelet transfusions. Eighty-four percent were given RBC transfusions, and 54% required intravenous antibiotics for fever while neutropenic. Conclusion: Mini-BEAM is a safe and effective regimen for treatment of refractory or relapsed Hodgkin's disease. Further studies are required to determine if responding patients have improved disease-free survival (DFS) after intensive therapy and ABMT.

Original languageEnglish (US)
Pages (from-to)396-402
Number of pages7
JournalJournal of Clinical Oncology
Volume13
Issue number2
StatePublished - Feb 1 1995

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Colwill, R., Crump, M., Couture, F., Danish, R., Stewart, A. K., Sutton, D. M. C., Scott, J. G., Sutcliffe, S. B., Brandwein, J. M., & Keating, A. (1995). Mini-BEAM as salvage therapy for relapsed or refractory Hodgkin's disease before intensive therapy and autologous bone marrow transplantation. Journal of Clinical Oncology, 13(2), 396-402.