Evaluating the results of CEAM regimen as a conditioning regimen for autologous stem cell transplantation in 25 patients with NHL

Ehsani, M. and Irvani, M. and Ghavamzadeh, A. and Safavifar, F. and Shamshiri, A.R. (2009) Evaluating the results of CEAM regimen as a conditioning regimen for autologous stem cell transplantation in 25 patients with NHL. Feyz Journal of Kashan University of Medical Sciences, 13.

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Official URL: http://feyz.kaums.ac.ir/article-1-741-en.html
DOI: UNSPECIFIED

Abstract

Background: An effective and useful therapy for NHL patients (relapsed or with incomplete response) is autologous bone marrow/peripheral blood stem cell transplantation (SCT). In this case, the type of conditioning regimen is an important factor for transplant outcome. This study carried out for evaluating the results of CEAM regimen as a conditioning regimen for autologous stem cell transplantation in 25 patients with NHL in Dr Shariati hospital bone marrow transplantation research center, Tehran University of medical sciences. Materials and methods: In this survival study 25 patients were selected according to inclusion criteria: ages between 14-60 years old, in complete or partial remission, in any stage and grade, with good function of bone marrow, heart, kidney and liver, and good performance status. After introducing mobilization regimen with G-CSF alone or with cyclophosphamide, the conditioning regimen (CEAM) was applied to the patients. After transplantation all patients were evaluated for rate of infection, hematologic engraftment, conditioning related organ toxicities and number of transfused packed cell and platelet units. In follow-up period after discharge, patients had regular examinations for B symptoms, lymph nodes and laboratory tests. Results: The peripheral blood was the stem cell source of all patients except one. At transplantation time, 6 (24) were in the first complete remission, 11 (44) in the second, 6 (26) in third and 2 (8) in partial remission. The mean duration of hospitalization after SCT was 25.5 days. From 25 person under going autologous transplantation, 16 (64) did not have relapse 8 (32) had relapse, and one person never had any response to transplant. Mortality rate in this study was 5(20). One-year overall survival (OS) was 78.4 (SE=8.6) two-year overall survival was the same. One-year and two-year disease free survival (DFS) were 70 (SE=9.5) and 59.1 (SE=10.7), respectively . The most common different organ toxicity in admission interval was as follow: Hematologic and gastrointestinal toxicities were seen in 100. The grade IV hematologic toxicities were 96 granulocytopenia, 20 anemia and 52 thrombocytopenia. The greatest part of mucositis in grade I (40), nausea and vomiting in grade II (respectively 44 and 52) were seen. Fever and infection, with or without positive culture, occurred during hospitalization in all patients except one (96). Overally the patients well tolerated the toxicities. Conclusion: According to the results, CEAM regimen can be suggest the as a good alternative for BEAM regimen with the added benefits of shorter duration of conditioning regimen (4 days vs. 6 days), no need for stem cell cryopreservation, no need for cold chain required for BCNU replaced by CCNU, better one year DFS result than previous conditioning regimen in this center (70 vs 30) and tolerable treatment associated toxicities.

Item Type: Article
Subjects: Medicine
Divisions: Feyz journal
Depositing User: ART . editor
Date Deposited: 10 May 2017 16:03
Last Modified: 28 May 2017 12:53
URI: http://eprints.kaums.ac.ir/id/eprint/2024

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