Mohammed Amine Bekadja*
Hematology and Cell Therapy Department, University Hospital of Oran, Algeria
Received date: date September 17, 2014; Accepted date: date September 22, 2014; Published date: date September 24, 2014
Citation: Bekadja MA (2016) EAM as a New Conditioning Regimen for Lymphoma Patients Undergoing Autologous Progenitor Cell Transplantation . J Blood Lymph 4:e115. doi:10.4172/2165-7831.1000e115
Copyright: © 2014 Bekadja MA, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Autologous progenitor cells transplantation; Etoposide; Cytarabine; Melphalan
Autologous progenitor cells transplantation (APCT) after a high dose conditioning chemotherapy is now an established treatment modality for many hematological malignancies such as lymphoma . Clinical results and survival after APCT depend on disease chemo sensitivity at transplant and the efficacy of the conditioning regimen at eradicating the residual tumor cell clone .
The impact of the conditioning regimen is a controversial matter and despite efforts to identify high-dose regimens with increasing antitumor activity and acceptable toxicity to normal tissues, there is not yet clear evidence of a superior conditioning platform that should be applied in the setting of recurring lymphoma patients, at least in terms of tumor-eradicating capacity.
In lymphoma, the protocols used were of more different type: CBV, BEAM , BEAC  CEAM , FEAM  or LACE . CBV and BEAM are the two most frequently used regimens for patients with lymphoma undergoing autologous progenitor cells transplantation (APCT). A BEAM regimen is a widely used conditioning regimen for autologous progenitor cells transplant in patients with Hodgkin lymphoma and non-Hodgkin lymphoma because of its acceptable toxicity and high effectiveness. Adverse events associated with BEAM are related in part to BiCNU .
In overall, the outcomes were following: median time to neutrophil (>500×109/l) and platelet (>20,000×109/l) engraftment was between 11 to 14 days and 13 to 19 days respectively. The mean of the transplant-related mortality (TRM) was between 3 to 7%. The overall survival at 8 years of patients conditioned with BEAM or BEAC (58%) was more favorable than with CBV (40%), and significantly better than with CY-TBI (31%).
Throughout the years from 2011 to 2012, seventeen patients received the EAM conditioning regimen in our department as follows: Etoposide (total dose of 800 mg\m2), Cytarabine (total dose of 8000 mg\m2) and Melphalan 140 mg/m2. The median age was 28 years (range: 17-48). All patients had a full hematopoietic reconstitution.
Median time to achieve neutrophils >500 /μl was 13 days (range: 10-19) and median time to achieve an unsupported platelet count >20,000/μl was16 days (range: 14-25). Toxicities included grade 4 hematologic in all patients, grade 3 mucositis in 4, grade 3 infectious in 2. One patient died at 100-Day (TRM=5,8%). After a median follow up of 34 months, the overall survival was 67% at 41 months, 13 patients are alive and 12 are in continuous complete remission.
In conclusion, these data demonstrate the safety and feasibility of EAM regimen as a new and modified regimen. Although these outcomes are encouraging, and comparison with other traditional APCT regimens used for patients with lymphoma is warranted.