Autologous Bone Marrow Transplantation - Blog Science Connections

328 Proposed International Adult Lymphoma Study
BEAC
The review of 100 cases of relapsed or progressive disease with no adults
with non-Hodgkin's lymphoma achieving CR has shown no significant difference
in the response and survival rates for the 39 patients who received TBI
compared with the 61 who received only chemotherapy (Fig 12). In this study
of 100 cases, 11 of 39 patients died of toxicity in the group receiving TBI,
whereas only 10 of 61 died of toxicity in the group receiving no TBI. It appears
that TBI did not significantly increase efficacy but did increase toxicity.
The BEAM protocol (BCNÜ [carmustine], etoposide, ara-C [cytarabine],
melphalan) was initiated in France in 1983 with the objective of reducing the
high number of toxic deaths related to BACT (BCNÜ [carmustine], ara-C
[cytarabine], cyclophosphamide, 6-thioguanine) protocol treatment (see
Biron et at, "A Phase II Study of a New Cytoreductive Conditioning Regimen
With Autologous Bone Marrow Transplantation for Lymphomas: The BEAM
Protocol," in this volume). Since 1984, 51 patients have been treated with
BEAM in the France Autogreffe Study group; 7 patients with Hodgkin's
disease and 44 with non-Hodgkin's lymphoma were included. Among the
latter, 28 were in relapse (9 RRs and 19 SRs). Five were in first PR, and 11 were
in first CR. The response rate was 73%, which was comparable to that in
previous BACT experience. As expected, toxicity was reduced, the toxicityrelated
death rate being 9.8% (5 of 57 patients) (see the above-named chapter
by Biron et al. in this volume). The BEAC protocol proposed for this study
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Figure 12. Comparison of survival in 100 patients with relapsed or progressive disease, 39
of whom underwent total body irradiation {TBI) and 61 of whom did not. The difference
between the two groups in the percentage surviving was not significant (NS); however,
because 11 of the 39 patients treated with TBI and only 10 of the group of 61 not treated
died of toxicity, it appears that TBI did not significantly increase efficacy but did increase
toxicity.