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High-dose glucocorticoids such as prednisone are combined with cytotoxic chemotherapy in the R-CHOP or dose adjusted R-EPOCH regimens used for non-Hodgkin lymphoma (NHL). In this retrospective study, our primary objective was to evaluate the incidence of hyperglycemia during first-line R-CHOP or DA-EPOCH-R. The secondary objectives were to evaluate the incidence of chemotherapy alteration and overall survival in those with and without hyperglycemia. One hundred and sixty patients were eligible. We found that 47% of all patients had at least one hyperglycemic episode and hyperglycemia was associated with chemotherapy alteration (p = .028). Multivariate analysis revealed international prognostic index (IPI) ≥ 3 (p = .045) and chemotherapy alteration (p = .001) were associated with decreased overall survival. We conclude that hyperglycemia is common during first-line NHL treatment with R-CHOP or DA-EPOCH-R, even in the absence of known diabetes and is associated with alterations of chemotherapy. Baseline pre-PET scan fasting blood glucose of 100 mg/dL or higher may predict hyperglycemia during therapy. [ABSTRACT FROM AUTHOR]

Mainstay treatment options for patients with relapsed or refractory Hodgkin's lymphoma and Non-Hodgkin's lymphoma (NHL) include high dose chemotherapy and autologous stem cell transplantation (aSCT). Several chemotherapy regimens have been explored with various drug combinations. To date, no objective data is available to indicate that one particular regimen is better than another in regards to superiority. When selecting one regimen compared to another, the choice will depend on each institution's individual practices, guidelines, and toxicities associated with each regimen. To report the safety and efficacy of the widely utilized BEAM (carmustine, etoposide, cytarabine, and melphalan) regimen in lymphoma patients at least 60 years of age who received an aSCT. This was a single center, retrospective, chart review at Wake Forest Baptist Medical Center's Comprehensive Cancer Center from January 2014 to September 2019. Patients were selected via report generation if they had received BEAM as a preparative regimen during the study period. Patients received carmustine 300 mg/m2 IV on Day -6; etoposide 200 mg/m2 IV Day -5 to Day -2; cytarabine 200 mg/m2 IV Day -5 to Day -2; and melphalan 140 mg/m2 IV Day -1. The primary endpoint was the prevalence of grade 3, 4, and 5 toxicities in BEAM. Secondary endpoints included relapse-free survival (RFS), overall survival (OS), time to death, time to relapse, and days to engraftment. Descriptive statistics were utilized for demographic data. Time to event data was analyzed using the Kaplan-Meier method. Fifty patients were included within this analysis. All patients experienced at least one adverse event with BEAM. The most commonly reported toxicities were gastrointestinal related events including nausea/vomiting (80%) and diarrhea (94%). The most commonly reported grade 3 or 4 event was febrile neutropenia (76%). There were no grade 5 related adverse events. Three year overall survival was 70% (n=26) and no patients died within the first 60 days post-transplant. The average length of stay was 20.1 days but when patients were moved to the outpatient setting for aSCT with BEAM our average length of stay decreased to 18.1 day. The patients who were transplanted outpatient had an overall length of stay of 5 days. The time to engraftment was 11 days for neutrophils and 18 days for platelets. BEAM was considered tolerable in the elderly lymphoma patient population with minimal grade 3 or 4 adverse events other than febrile neutropenia. The nausea and vomiting and diarrhea that occurred was such that it allowed the transition to the outpatient setting. Additionally, the administration of cytarabine and etoposide daily made administration in the outpatient setting feasible. [ABSTRACT FROM AUTHOR]