BACE (Bendamustine, Cytarabine, Cyclophosphamide and Etoposide) conditioning regime for patients with lymphoma undergoing autologous stem cell transplant

Autologous stem cell transplant (ASCT) is a curative treatment for lymphomas. BEAM conditioning (Carmustine, Etoposide, Cytarabine, Melphalan) is widely used but can cause severe side effects. This study investigated the effectiveness and safety of a BACE regimen (Bendamustine, Cytarabine, Etoposide, Cyclophosphamide) as an alternative to BEAM in patients with relapsed/refractory lymphomas. The study included 28 patients who received BACE followed by ASCT. The results showed good tolerability with minimal grade III-IV mucositis, no pulmonary or renal toxicity, and a low transplant-related mortality rate (0% at day 30). The overall survival rate at 2 years was 77%, and the relapse-free survival rate was 85%. Compared to other BCNU-alternative regimens, BACE demonstrated favorable outcomes with a lower relapse rate (14.3%). Engraftment times were also faster compared to BCNU-containing regimens. Limitations include the single-center design and the potential selection bias due to pre-transplant response. Further research with larger patient groups is needed to confirm these findings. This study suggests that BACE could be a promising alternative to BEAM for ASCT in relapsed/ refractory lymphomas, offering similar effectiveness with potentially reduced side effects.