evaluating the efficacy of modified beeam (bendamustine, etoposide, cytarabine, melphalan) regimen as conditioning for autologous stem cell transplantation in relapsed or refractory lymphoma: an experience from two centers of a developing country

Background: high-dose chemotherapy followed by autologous sct (stem cell transplantation) is a treatment of choice for relapsed and refractory lymphoma. due to cost, toxicity, and shortage of carmustine, we decided to conduct a phase 2 clinical trial to evaluate the safety and efficacy of bendamustine instead of carmustine in a previously used beam-like protocol.materials and methods:102 patients (median age,37) with hodgkin(n=54) and non-hodgkin lymphoma(n=48) were recruited and transplanted in two centers. after stem cell harvesting, a modified beeam regimen was administered to all the patients. overall survival and disease-free survival (dfs) at two years were calculated as the study's primary endpoints.results: neutrophil and platelet recovery were observed after a median of 12 and 13 days, and all the patients were engrafted. fever was observed in 25(24.5%) with only two documented infections. the only grade iii toxicities were mucositis (20%) and nausea (15.6%). no transplant-related mortality (trm) was observed after 100 days. after a median follow-up of 37(range 25-48) months, 68(66.6%) patients were in complete remission while 21 patients were in partial response, and 16 patients(15.6%) developed progressive disease, among which 13 (12.7%) had died. the os at two years was (89 of 102, 87.3%), and the dfs rate was 68 of 102=66.7%.conclusion: our study showed that modified beeam is a safe, effective, and feasible conditioning regimen for asct in lymphoma instead of the beam regimen.