The preliminary results of treatment ofadvanced and recurrent malignant lymphoma by beac regimen supported with autologous hematopoietic stem cells transplantation

Objective: High dose chemotherapy supported by autologous hematopoietic stem cells transplantation (AHSCT) has developed dramaticly in recent years and become the most effective approach to improve radical treatment for the chemo-sensitive lymphoma. The purposes of this study was to evaluate the efficacy and tolerance of preparative regimen BEAC and hematopoietic reconstitution after high dose chemotherapy in Chinese patients with advanced and recurrent lymphoma. Methods: After confirmed complete or partial remission from conventional chemotherapy, 24 patients with advanced or recurrent lymphoma including 1 recurrent HD and 23 NHL, 16 male and 8 female with median age of 29 (13–50) years, were enrolled into this study and treated by BEAC regimen (CTX 3600–4000 mg/m 2 , VP-16 1200 mg/m 2 . BCNU 300 mg/m 2 and Ara-C 1500–2000 mg/m 2 ). 3 patients were supported by ABMT and 21 by APBSCT. Mobilization regimen for APBSCT was CTX 3500 mg/m 2 + G-CSF 3.5–5 µg/kg + Dexamethasone 10 mg. Autologous hematopoietic stem cells was re-infused 24–48 h after completion of high dose chemotherapy. Results: MNC 1.3 (1.0–1.7)×10 8 /kg and MNC 1.8 (1.0–4.4)×10 8 , CFU-GM 5.1 (1.9–9.6)×10 5 /kg plus CD34 + cells 2.9 (1.9–8.7)×10 6 /kg were re-infused in the ABMT group and APBSCT group respectively. All patients obtained prompt and sustained hematopoietic reconstitution. ANC≥0.5×10 9 /L and Pt≥2.0×10 9 /L were at day 9 (6–17) and day 10 (0–31) respectively. 16 patients were alive with median 21 (2–69) months follow-up till end of May, 2001. 1, 2 and 3 years survival rate were 60.5%, 50.1% and 50.1%, respectively. Non-hematologic toxicity was mild and tolerable. Conclusions: High dose chemotherapy supported by AHSCT in the treatment of previously-untreated poor-prognostic and recurrent lymphoma was a safe and effective modality. Further investigation was warranted.