165 Severe Mucositis with Bendamustine Etoposide Ara-C and Melphalan (Be-EAM) As Conditioning Regimen in Non-Hodgkin Lymphoma (NHL) Patients Undergoing Autologous Stem Cell Transplantation (AutoSCT)

Track: Poster Abstracts
Wednesday, February 11, 2015, 6:45 PM-7:45 PM
Grand Hall CD (Manchester Grand Hyatt)
Antonio M Jimenez, MD , Rush University Medical Center, Chicago, IL
Sunita Nathan, MD , Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL
Alfonso D Moreno , Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL
John Maciejewski, MD, PhD , Section of Bone Marrow Transplantation and Cell Therapy, Rush University Medical Center, Chicago, IL
Henry C Fung, MD , Bone Marrow Transplant Program, Temple University Hospital/Fox Chase Cancer Center, Philadelphia, PA
Presentation recording not available for download or distribution as requested by the presenting author.
Introduction:Bendamustine is effective for front-line or salvage therapy in patients (pts) with NHL.  Benda-EAM conditioning has been used in heavily pre-treated relapsed/ refractory lymphoma pts undergoing autologous stem cell transplantation (AutoSCT) and is noted to be a safe and effective regimen.  We report our experience with using Be-EAM conditioning regimen for AutoSCT with special note on the toxicity profile.

Methods:Data from 22 consecutive patients (pts), undergoing AutoSCT using the Be-EAM [Bendamustine200mg/m2 daily D-7,-6, Etoposide 200mg/m2 daily D-5 to -2, Ara-C 200mg/m2 Q12 D-5 to -2 and Melphalan 140mg/m2 on D-1], treated at our institution between 2011 and 2013, were collected.  Demographics, indication for AutoSCT, time to engraftment (TE), side effect profile, tolerability and outcomes were analyzed.  WHO oral mucositis score was used for grading mucositis.

Results:22 pts (average age 60.36 yrs, range: 39-72 yrs) were identified and analyzed as a retrospective cohort with a follow-up duration of 26.1 months (Range 9-43 mos). 15 (68%) pts were male and 7 (32%) pts female. 72.7% were Caucasian.  8 (36.4%) pts had ≥2 comorbidities. Indication for AutoSCT included relapsed/refractory follicular lymphoma, diffuse large B cell lymphoma and lymphoplasmacytic lymphoma and upfront consolidation for mantle cell lymphoma. 8 (36.4%) pts underwent AutoSCT as consolidative therapy and 14 (63.6%) pts for relapsed/ refractory disease. Therapies prior to AutoSCT were 1-3 regimens. Time to engraftment was 11.7±1.79 days for neutrophils and 15.32±2.6 days for platelets. Be-EAM-related toxicities included nausea, emesis, diarrhea, neutropenic fever and mucositis. 13 (59%) pts had severe mucositis (Grade 3/4) with 5 pts developing neutropenic enterocolitis including 1 patient with pneumatosis intestinalis.  Overall, 18 (81.8%) pts were in CR and 2 (9%) pts had minimal disease at D100. 5 (22.7%) pts had relapsed disease. 4 (18.2%) pts died from relapsed or progressive disease.

Conclusion: Bendamustine based conditioning is an effective regimen in patients with NHL undergoing autologous stem cell transplantation as previously reported.  It has the potential of causing severe mucositis irrespective of age, comorbidities, disease type or number of prior therapies.  This regimen although moderately tolerated should be used cautiously especially in patients who have had prior therapies that can affect the gastrointestinal tract.

Disclosures:
Nothing To Disclose
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