Cancer Medicine (Dec 2024)
Mitoxantrone‐Based Novel Conditioning Regimen Leads to Great Survival Benefit in Peripheral T‐Cell Lymphoma Compared to BEAM Regimen
Abstract
ABSTRACT Background Peripheral T‐cell lymphomas (PTCL) frequently result in relapsed or refractory diseases. Upfront autologous hematopoietic stem cell transplantation (ASCT) using the BEAM (carmustine, etoposide, cytarabine, and melphalan) regimen is recommended. However, relapses are common in PTCL, highlighting a critical need for improved survival outcomes in these patients. Objective Anthracycline drugs are essential in treating PTCL. We compared the efficacy and tolerability of a high‐dose mitoxantrone‐based conditioning regimen [mitoxantrone, cyclophosphamide, and etoposide (MCE)] to the BEAM regimen in upfront ASCT for newly diagnosed PTCL patients who achieved complete or partial remission after induction therapy. Study Design A retrospective study was conducted to analyze the treatment response, progression‐free survival (PFS), overall survival (OS), hematologic engraftment time, and adverse events of 64 patients between two regimens, who achieved complete or partial remission after induction chemotherapy. Twenty‐eight patients received the MCE regimen, while 36 patients were treated with the BEAM regimen. Results There were no significant differences in clinical characteristics or the incidence of adverse events between the two groups. However, the median OS significantly favored the MCE group at 102.4 (95% CI, 87.0–117.8) months compared to 62.6 (95% CI, 50.8–74.5) months in the BEAM group (p = 0.023). Similarly, the median PFS was longer in the MCE group at 87.8 (95% CI, 65.8–109.8) months versus 42.5 (95% CI, 30.0–55.0) months in the BEAM group (p = 0.031). Conclusion ASCT with the mitoxantrone‐based conditioning regimen is tolerable and appears to significantly improve the prognosis of PTCL patients, offering a promising alternative to the current standard of care.
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