Autologous Peripheral Blood Stem Cell Transplant Using BEAM or CBV without Cryopreservation. 82 Procedures in Patients with Relapsed Hodgkin and Non- Hodgkinxs Lymphoma

Small series have shown that it is possible perform autologous hematopoietic transplant in lymphoma patient without cryopreservation. In most of them, CBV like or BEAM  likeregimen were used, but with important modifications of the intensity of dose delivered, or  using different drugs . We present our experience in a large group of lymphoma patients using non-cryopreserved stem cells after administration of BEAM or CBV without alteration of the total amount of chemotherapy of these regimens

 The mobilization was done with filgrastin 5 mg/kg/BID for five to six days, after that, one or two leukopheresis of 3 to 5 blood volume was done; the cells were stored at 4oC, 6 days for first leukopheresis, and 5 for the second one. The preparative regimen began in the evening of the last pheresis, this was the day – 5. All patients received filgrastim or pegfilgrastim after the transplant

 Preparative regimens

BEAM	D-5	D-4	D-3	D-2	D-1
Etoposido 200-300 mgs/m2/day	X	X	X	X
BiCNU 300 mgs/m2/day	X
Citarabine 300 mgs/m2/day		X	X	X
Melfalan 140 mgs/m2/day				X
CBV
Cyclosphaphamide 2.000 mgs/m2/day			X	X	X
BiCNU 300 mgs/m2/day	X
Etoposide 300 mgs/m2/day	X	X	X

 82 ptes in whom were collected at least 1.0 x 10(6) CD 34/kg (X: 2.5) were transplanted; 49 were men, median age was 36 Y (11-65), 42 had Hodgkin disease and 40 had lymphoma, the totality of them were in CR2 or beyond.  65 received BEAM and 17 CBV. The median viability of the cells after 6 days of refrigeration (trypan blue exclusion) was 82% (range 66-90). All patients had fast and complete neutrophil engraftment; median time to achieve 500/ul or more was 12 days (9-23), 79 were evaluable for thrombopoiesis, 78 of them had a self- sustained platelets count of 20.000 or more at a median of 17 days (range 9-50). There has not been secondary engraftment failure

The tolerance and efficacy of the BEAM and CBV administered in 5 days was good; the transplant related mortality was 3.6% and the Kaplan Meir estimate for OS at  36  months was 65%  and 58%  for patients with Hodgkin and lymphoma respectively

We conclude; the use of non-cryopreserved stem cell for supporting autologous transplant after a BEAM or CBV conditioning is feasible, safe, and produce a fast, complete and sustained hematopoiesis. This simple procedure is a good alternative for saving costs and it can expand the number of lymphoma patients who would receive the benefit of tranplant