@article{b210dd48defa4b81916028eb2c9a89d9,
title = "Outcomes of rituximab-BEAM versus BEAM conditioning regimen in patients with diffuse large B cell lymphoma undergoing autologous transplantation",
abstract = "Background: Although rituximab-based high-dose therapy is frequently used in diffuse large B cell lymphoma (DLBCL) patients undergoing autologous hematopoietic cell transplantation (auto-HCT), data supporting the benefits are not available. Herein, we report the impact of rituximab-based conditioning on auto-HCT outcomes in patients who have DLBCL. Methods: Using the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, 862 adult DLBCL patients undergoing auto-HCT between 2003 and 2017 using BEAM (BCNU, etoposide, cytarabine, melphalan) conditioning regimen were included. All patients received frontline rituximab-containing chemoimmunotherapy and had chemosensitive disease pre-HCT. Early chemoimmunotherapy failure was defined as not achieving complete remission (CR) after frontline chemoimmunotherapy or relapse within 1 year of initial diagnosis. The primary outcome was overall survival (OS). Results: The study cohort was divided into 2 groups: BEAM (n = 667) and R-BEAM (n = 195). On multivariate analysis, no significant difference was seen in OS (P =.83) or progression-free survival (PFS) (P =.61) across the 2 cohorts. No significant association between the use of rituximab and risk of relapse (P =.15) or nonrelapse mortality (P =.12) was observed. Variables independently associated with lower OS included older age at auto-HCT (P '.001), absence of CR at auto-HCT (P '.001) and early chemoimmunotherapy failure (P '.001). Older age (P '.0002) and non-CR pre-HCT (P '.0001) were also associated with inferior PFS. There was no significant difference in early infectious complications between the 2 cohorts. Conclusion: In this large registry analysis of DLBCL patients undergoing auto-HCT, the addition of rituximab to the BEAM conditioning regimen had no impact on transplantation outcomes. Older age, absence of CR pre auto-HCT, and early chemoimmunotherapy failure were associated with inferior survival.",
keywords = "BEAM, autologous transplantation, chemoimmunotherapy, diffuse large B cell lymphoma, rituximab",
author = "Deepa Jagadeesh and Majhail, {Navneet S.} and Yizeng He and Ahn, {Kwang W.} and Carlos Litovich and Sairah Ahmed and Mahmoud Aljurf and Ulrike Bacher and Badawy, {Sherif M.} and Nelli Bejanyan and Mitchell Cairo and Jan Cerny and Narendranath Epperla and Nosha Farhadfar and Freytes, {C{\'e}sar O.} and Gale, {Robert Peter} and Bradley Haverkos and Nasheed Hossain and David Inwards and Kamble, {Rammurti T.} and Kenkre, {Vaishalee P.} and Lazarus, {Hillard M.} and Aleksandr Lazaryan and Lazaros Lekakis and Matthew Mei and Murthy, {Hemant S.} and Alberto Mussetti and Sunita Nathan and Taiga Nishihori and Olsson, {Richard F.} and {Ramakrishnan Geethakumari}, Praveen and Savani, {Bipin N.} and Yared, {Jean A.} and Fenske, {Timothy S.} and Kharfan-Dabaja, {Mohamed A.} and Anna Sureda and Mehdi Hamadani",
note = "Funding Information: The CIBMTR is supported primarily by Public Health Service grant/cooperative agreement U24CA076518 with the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI), and the National Institute of Allergy and Infectious Diseases (NIAID); grant/cooperative agreement U24HL138660 with the NHLBI and NCI; grant U24CA233032 from the NCI; grants OT3HL147741, R21HL140314, and U01HL128568 from the NHLBI; contract HHSH250201700006C with the Health Resources and Services Administration (HRSA); grants N00014‐18‐1‐2888 and N00014‐17‐1‐2850 from the Office of Naval Research; subaward from prime contract award SC1MC31881‐01‐00 with the HRSA; subawards from prime grant awards R01HL131731 and R01HL126589 from the NHLBI; subawards from prime grant awards 5P01CA111412, 5R01HL129472, R01CA152108, 1R01HL131731, 1U01AI126612, and 1R01CA231141 from the NIH; and commercial funds from Actinium Pharmaceuticals, Adaptive Biotechnologies, Allovir, Amgen, an anonymous donation to the Medical College of Wisconsin, Anthem, Astellas Pharma US, Atara Biotherapeutics, BARDA, Be the Match Foundation, bluebird bio, Boston Children's Hospital, Bristol‐Myers Squibb, Celgene, Children's Hospital of Los Angeles, Chimerix, City of Hope Medical Center, CSL Behring, CytoSen Therapeutics, Daiichi Sankyo, Dana Farber Cancer Institute, Enterprise Science and Computing, Fred Hutchinson Cancer Research Center, Gamida‐Cell, Genzyme, Gilead Sciences, GlaxoSmithKline, HistoGenetics, Immucor, Incyte Corporation, Janssen Biotech, Janssen Pharmaceuticals, Janssen Research & Development, Janssen Scientific Affairs, Japan Hematopoietic Cell Transplantation Data Center, Jazz Pharmaceuticals, Karius, Karyopharm Therapeutics, Kite Pharma, Kyowa Kirin, Magenta Therapeutics, Mayo Clinic and Foundation (Rochester, Minnesota), Medac, Mediware, Memorial Sloan Kettering Cancer Center, Merck & Company, Mesoblast, MesoScale Diagnostics, Millennium, the Takeda Oncology Co., Miltenyi Biotec, Mundipharma EDO, National Marrow Donor Program, Novartis Oncology, Novartis Pharmaceuticals Corporation, Omeros Corporation, Oncoimmune, OptumHealth, Orca Biosystems, PCORI, Pfizer, Phamacyclics, PIRCHE AG, Regeneron Pharmaceuticals, REGiMMUNE, Sanofi Genzyme, Seattle Genetics, Shire, Sobi, Spectrum Pharmaceuticals, St. Baldrick's Foundation, Swedish Orphan Biovitrum, Takeda Oncology, the Medical College of Wisconsin, the University of Minnesota, the University of Pittsburgh, the University of Texas MD Anderson Cancer Center, the University of Wisconsin–Madison, Viracor Eurofins, and Xenikos BV. The views expressed in this article do not reflect the official policy or position of the NIH, the Department of the Navy, the Department of Defense, the HRSA, or any other agency of the US Government. Funding Information: The CIBMTR is supported primarily by Public Health Service U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); U24HL138660 from NHLBI and NCI; OT3HL147741, R21HL140314 and U01HL128568 from the NHLBI; HHSH250201700006C, SC1MC31881-01-00 and HHSH250201700007C from the Health Resources and Services Administration (HRSA); and N00014-18-1-2850, N00014-18-1-2888, and N00014-20-1-2705 from the Office of Naval Research; Additional federal support is provided by P01CA111412, R01CA152108, R01CA215134, R01CA218285, R01CA231141, R01HL126589, R01AI128775, R01HL129472, R01HL130388, R01HL131731, U01AI069197, U01AI126612, and BARDA. Support is also provided by Be the Match Foundation, Boston Children's Hospital, Dana Farber, Japan Hematopoietic Cell Transplantation Data Center, St. Baldrick's Foundation, the National Marrow Donor Program, the Medical College of Wisconsin and from the following commercial entities: AbbVie; Actinium Pharmaceuticals, Inc.; Adaptive Biotechnologies; Adienne SA; Allovir, Inc.; Amgen, Inc.; Anthem, Inc.; Astellas Pharma US; AstraZeneca; Atara Biotherapeutics, Inc.; bluebird bio, Inc.; Bristol Myers Squibb Co.; Celgene Corp.; Chimerix, Inc.; CSL Behring; CytoSen Therapeutics, Inc.; Daiichi Sankyo Co., Ltd.; Gamida-Cell, Ltd.; Genzyme; GlaxoSmithKline (GSK); HistoGenetics, Inc.; Incyte Corporation; Janssen Biotech, Inc.; Janssen Pharmaceuticals, Inc.; Janssen/Johnson & Johnson; Jazz Pharmaceuticals, Inc.; Kiadis Pharma; Kite Pharma; Kyowa Kirin; Legend Biotech; Magenta Therapeutics; Mallinckrodt LLC; Medac GmbH; Merck & Company, Inc.; Merck Sharp & Dohme Corp.; Mesoblast; Millennium, the Takeda Oncology Co.; Miltenyi Biotec, Inc.; Novartis Oncology; Novartis Pharmaceuticals Corporation; Omeros Corporation; Oncoimmune, Inc.; Orca Biosystems, Inc.; Pfizer, Inc.; Phamacyclics, LLC; Regeneron Pharmaceuticals, Inc.; REGiMMUNE Corp.; Sanofi Genzyme; Seattle Genetics; Sobi, Inc.; Takeda Oncology; Takeda Pharma; Terumo BCT; Viracor Eurofins and Xenikos BV. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government. Publisher Copyright: {\textcopyright} 2020 American Cancer Society",
year = "2020",
month = may,
day = "15",
doi = "10.1002/cncr.32752",
language = "English (US)",
volume = "126",
pages = "2279--2287",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "10",
}