Lenfomalı Hastalarda Otolog Kök Hücre Nakli Hazırlık Rejimi Olarak BuCy-E ve BEAM Protokollerinin Retrospektif Karşılaştırılması

Yıl 2024, , 523 - 529, 12.01.2025

Tuba Güllü Koca , Vildan Ozkocaman , Sinem Çubukçu , Fazıl Cagrı Hunutlu , Şeyma Yavuz , Ezel Elgun , Tuba Ersal , Fahir Özkalemkaş

https://doi.org/10.32708/uutfd.1571600

Öz

Bu çalışma, relaps/refrakter malign lenfomalarda kullanılan otolog kök hücre nakli (OKİT) için iki farklı hazırlık rejimi olan BuCy-E ve BEAM'in etkinliği ve toksisite profillerini karşılaştırmaktadır. BuCy-E ve BEAM, lenfoma tedavisinde yaygın olarak kullanılan iki hazırlık rejimidir ve bu çalışmada her iki rejimin kısa dönem sonuçları retrospektif olarak incelenmiştir. On ikisi Hodgkin Lenfoma (HL) ve 18'i Non-Hodgkin Lenfoma (NHL) tanısı alan toplam 30 hasta çalışmaya alınmıştır. Hastaların demografik özellikleri, tedavi yanıtları, yan etkiler ve toksisiteleri kaydedilmiştir. Elde edilen bu veriler her iki rejim için istatistiksel olarak karşılaştırılmıştır. Her iki grup arasında yaş, cinsiyet ve tanı açısından anlamlı bir fark bulunmamıştır. Febril nötropeni BEAM grubunda istatistiksel olarak daha yüksek oranda bulunmasına rağmen fungal enfeksiyonlar arasındaki fark istatistiksel anlamlılığa ulaşamamıştır. BEAM grubunda şiddetli mukozit daha sık görülmüştür. Her iki grupta bulantı, kusma ve diyare benzer seviyelerde görülmüştür. BEAM grubu, median PFS açısından BuCy-E’ye göre anlamlı şekilde daha üstün bulunmuştur (23 ay vs. 12 ay, p = 0.0044). Median OS’de ise BEAM grubu daha avantajlı görünmekle birlikte (23 ay vs. 12 ay), bu fark istatistiksel olarak anlamlı değildir (p = 0.179). BuCy-E ve BEAM rejimleri, kısa dönem toksisite profilleri açısından karşılaştırılabilir olup, BEAM rejimi PFS açısından üstün bir sağkalım sunmaktadır. Ancak, BEAM rejiminde febril nötropeni gibi yan etkilerin daha sık gözlenmesi dikkate alınmalıdır. OS açısından gruplar arasında istatistiksel olarak anlamlı bir fark bulunmamakla birlikte, uzun dönem sonuçlar için daha geniş hasta gruplarında ve uzun süreli takiplerle yapılacak prospektif çalışmalara ihtiyaç vardır. BuCy-E rejimi, daha düşük toksisite profili nedeniyle belirli hasta gruplarında etkin bir alternatif olarak değerlendirilebilir.

Anahtar Kelimeler

Lenfoma, hazırlık rejimi, BuCy-E, BEAM, OKIT

Retrospective Comparison of BuCy-E and BEAM Protocols as Autologous Stem Cell Transplant Preparation Regimen in Patients with Lymphoma

Öz

This study compares the efficacy and toxicity profiles of BuCy-E and BEAM, two different preparative regimens for autologous stem cell transplantation (ASCT) in relapsed/refractory malignant lymphomas. BuCy-E and BEAM are two commonly used preparative regimens for the treatment of lymphoma, and this study retrospectively analyzed the short-term outcomes of both regimens. Twelve patients with Hodgkin's Lymphoma (HL) and 18 patients with Non-Hodgkin's Lymphoma (NHL) were included in the study. Patient demographics, treatment response, side effects, and toxicities were recorded. These data were statistically compared for both regimens. No significant difference was found between the two groups in terms of age, gender, and diagnosis. Although febrile neutropenia was statistically higher in the BEAM group, the difference between fungal infections did not reach statistical significance. Severe mucositis was more common in the BEAM group. Nausea, vomiting, and diarrhea were observed at similar levels in both groups. Similar levels of nausea, vomiting and diarrhea were seen in both groups. The BEAM group was significantly superior to BuCy-E in median PFS (23 months vs. 12 months, p = 0.0044). In median OS, the BEAM group appeared more favorable (23 months vs. 12 months), but this difference was not statistically significant (p = 0.179). The BuCy-E and BEAM regimen were comparable in terms of short-term toxicity profiles, with the BEAM regimen offering superior survival in terms of PFS. However, it should be noted that side effects such as febrile neutropenia were observed more frequently in the BEAM regimen. Although there was no statistically significant difference between the groups in terms of OS, prospective studies with larger patient groups and long-term follow-up are needed for long-term results. BuCy-E regimen may be considered as an effective alternative in certain patient groups due to its lower toxicity profile.

Anahtar Kelimeler

Lymphoma, BuCy-E, BEAM, ASCT, preparative regimen

Kaynakça

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