Lijecnicki vjesnik 2018;140(11-12)
Use of bendamustin instead of carmustin in autologous stem cell transplantation conditioning – toxicity and infectious complications comparison
Ivan Zekanović, Nadira Duraković, Martina Morić Perić, Sandra Bašić-Kinda, Dubravka Sertić, Ranka Serventi Seiwerth, Silva Zupančić-Šalek, Pavle Rončević, Ivo Radman, Marijo Vodanović, Alen Ostojić, Goran Rinčić, Ines Bojanić, Vlatka Periša, Dominik Lozić, Vedrana Gačić, Ivana Budisavljević, Igor Aurer
Abstract
Summary. Inadequate supply of „old and less interesting“ chemotherapeutic agents is becoming a global issue in hemato-oncology today. In 2016 we were faced with occasional carmustin shortage, one of the most commonly used in autologous transplant conditioning regimens for lymphoma in our centre, so we decided to use bendamustin instead. We performed a retrospective analysis of 41 patients treated at our centre who had received bendamustin within BeEAM protocol and compared them with 40 patients who had received carmustin within BEAM protocol. Both protocols were used as conditioning protocols before autologous stem cell transplantation. Neutrophil recovery median following transplantation (ANC>0,5x10 9 /l) was 11 days in the bendamustin group in comparison to 10 days in the carmustin group.Platelets recovery median following transplantation (PLT>20x10 9 /l) was longer in the bendamustin group (16 vs.13 days) as was blood transfusion dependency (7 vs. 5 days). Infectious complications were not more frequent after bendamustin, but grade II–III mucositis was more frequent in patients who received carmustin (35% vs.12%). Following bendamustin we had one reported case of nephrotoxicity and cardiac toxicity, not reported with carmustin. Bendamustin has shown similar hematologic toxicity compared to carmustin but a longer platelet recovery period and a lower mucositis incidence.