Efficacy of CEAC regimen before autologous hematopoietic stem cell transplantation for non-Hodgkin lymphoma: analysis of 102 cases

Abstract

Objective To investigate the clinical efficacy and adverse reactions of CEAC conditioning regimen combined with autologous hematopoietic stem cell transplantation for treatment of non-Hodgkin lymphoma. Methods We conducted a retrospective analysis of 102 patients with non-Hodgkin lymphoma, who underwent autologous hematopoietic stem cell transplantation after CEAC conditioning regimen in our hospital from 2011 to 2017. The factors affecting the patients' survival, clinical efficacy of the treatment, neutrophil and platelet reconstitution time, and adverse events associated with the conditioning regimen were analyzed. Results Hematopoietic reconstruction was achieved successfully in 100 of the 102 patients. The median time of neutrophil and platelet reconstitution time was 10 d (7~17 d) and 12 d (7~33 d) in these cases, respectively. The main adverse reactions included nausea, vomit, fever, liver toxicity and diarrhea. The patients were followed up for a median of 42 months, during which disease progression occurred in 25 (24.5%) cases; death occurred in 18 (17.6%) cases, and 9 (8.8%) of these cases resulted from disease progression. The overall 3-year survival rate of the patients was 81.3%, with an overall 3-year progression-free survival rate of 77.5%. Univariate analysis showed that the disease type was a prognostic factor for the overall survival (P < 0.001) and progression-free survival (P < 0.001), and IPI score was a prognostic factor for progression-free survival (P=0.041). Multivariate analysis showed that the disease type (HR=0.144, 95%CI: 0.052~0.400, P < 0.001) was an independent prognostic factor for the overall survival; the disease type (HR=0.291, 95%CI: 0.133~0.637, P=0.002) and the pretransplant status (HR=1.940, 95%CI: 1.192~3.159, P=0.008) were independent prognostic factors for progression-free survival. The toxic reactions related with the conditioning regimen included nausea, vomiting, diarrhea, fever, and infections, and the transplant-related mortality rate was 1.96%. Conclusion CEAC conditioning regimen can achieve a good efficacy with tolerable adverse reactions in patients undergoing autologous hematopoietic stem cell transplantation for non-Hodgkin lymphoma.

Keywords

• autologous hematopoietic stem cell transplantation
• non-hodgkin lymphoma
• ceac conditioning regimen