Alternating mini-BEAM/ESHAP as salvage therapy for refractory non-Hodgkin's lymphomas |
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Authors: | M D Caballero M L Amigo J M Hernández L Vazquez C del Cañizo M Gonzalez R García J F San Miguel |
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Institution: | (1) Servicio de Hematología, Hospital Universitario de Salamanca, Paseo de San Vicente, 58–182, E-37007 Salamanca, Spain, ES |
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Abstract: | Mini-BEAM and ESHAP are two non-cross-resistant salvage regimens that have been used separately in patients with lymphoma.
The aim of the present study was to investigate the efficacy of the combination of these two regimens, administered in alternating
cycles, as salvage therapy for refractory non-Hodgkin's lymphoma (NHL) patients. A total of 28 patients were included in the
study: 14 patients were primary refractory, seven were partial responders, and seven were in relapse. The alternating cycles
of mini-BEAM and ESHAP were given until there was maximum response or progression. The overall response rate to mini-BEAM/ESHAP
was 39%; 25% of patients achieved a complete response and 14% a partial response. Nevertheless, it should be noted that none
of the primary refractory patients responded to this protocol. Nine of the 11 patients who responded to mini-BEAM/ESHAP were
consolidated with autologous transplantation using BEAM as a conditioning regimen. The survival at 3 years in this group of
11 patients who responded to the salvage regimen is 64%, with a disease-free survival of 67% at 2 years. No major toxic effects
were observed with mini-BEAM/ESHAP. Myelosuppression was the most frequent complication, especially with the mini-BEAM cycles.
Other toxicities were infrequent and no treatment-related deaths were observed. These results suggest that alternating mini-BEAM/ESHAP
chemotherapy is a safe regimen that is effective in partial responders or relapsing patients with NHL who have sensitive disease,
but not in primary refractory patients. Moreover, although this therapy has a potential advantage, combining as it does two
non-cross-resistant regimens, it does not seem superior to ESHAP alone.
Received: 16 July 1996 / Accepted: 31 October 1996 |
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Keywords: | Non-Hodgkin's lymphoma Refractory Salvage therapy |
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