Dexa-BEAM: An effective regimen for cytoreduction prior to high-dose chemotherapy with autologous stem cell support for patients with relapsed/refractory mantle-cell lymphoma

Mantle-cell lymphoma (MCL) is not a curable disease using conventional chem otherapy. Patients with MCL have the shortest median rime to progression an d the shortest median survival of all lymphoma subtypes after first-line tr eatment. In the present study we determined the efficacy of maximal cytored uctive therapy with up to four cycles of Dexa-BEAM (dexamethasone, carmusti ne [BCNU], etoposide, cytarabine, and melphalan) followed by high-dose chem otherapy (HDCT) and autologous hematopoietic stem cell support (ASCT) for p atients with advanced relapsed or refractory MCL, Nine consecutive patients with relapsed or refractory MCL were included. Three patients had partial remission (PR), three patients progressive disease (PD) upon first line tre atment, and three patients first or subsequent relapse. After 2 to four cyc les of Dexa-BEAM eight patients achieved complete remission (CR), resulting in a response rate of 88%. Six of 8 patients responding to Dexa-BEAM recei ved high-dose chemotherapy HDCT (BEAM) and autologous hematopoietic stem ce ll transplantation (ASCT). With a median follow up of 24 months six patient s are alive. Five of those six patients are still in continuous CR (range 1 3-54 months).