Morbidity and transplant-related mortality of CBV and BEAM preparative regimens for patients with lymphoid malignancies undergoing autologous stem-cell transplantation

CBV and BEAM are the two most frequently used regimens for patients with lymphoma undergoing autologous hematopoietic stem-cell transplantation ( ASCT). This study compared their morbidity and transplant- related mortality ( TRM) in 113 patients with non-Hodgkin's lymphoma ( 69) and Hodgkin's disease (44) undergoing ASCT between 1990 - 2004. CBV ( cyclophosphamide, 6000 mg m(-2); VP- 16, 750 mg m(-2); and high- dose BCNU, 800 mg m72) was administered to 75 patients and 38 received BEAM ( BCNU, 300 mg m72; VP- 16, 800 mg m72; cytarabine, 800 mg m72; melphalan, 140 mg m(-2)). Patients in the BEAM group had a significantly higher median age (p = 0.002) and were more heavily treated before ASCT (p = 0.003). More patients showed active disease at transplant in the BEAM group (p < 0.04). Sinusoidal obstruction syndrome ( SOS) was more frequent in the CBV group (11% vs 0%, p = 0.048). There were 20 (18%) transplantrelated deaths, 18 in the CBV and two in the BEAM group. Infectious complications ( 12 patients, seven with pneumonia) and SOS ( four) were the most frequent causes of death. The cumulative incidences of TRM were 25% in the CBV and 7% in the BEAM group ( p = 0.02). CBV thus produced a higher incidence of SOS and TRM than BEAM in this series.