Objective: Conditioning regimens used before autolog stem cell transplantation (ASCT) have a direct impact on post-transplant complications and infectious morbidity. The BEAM regimen (carmustine, etoposide, cytarabine, and melphalan) is frequently preferred for patients with Hodgkin and non-Hodgkin lymphomas, while high-dose melphalan is commonly used in multiple myeloma. This study aims to compare the incidence of febrile neutropenia (FN) in patients undergoing ASCT with either the BEAM or high-dose melphalan conditioning regimen.

In this study, febrile neutropenic patients who underwent autologous stem cell transplantation between 2010 and 2023 at the Hematology Department of Bursa Uludağ University Faculty of Medicine were analyzed. We evaluated the patients’ demographic and clinicopathological data, duration of FN episodes, depth of neutropenia, and length of hospital stay. Additionally, the causative pathogens of FN and FN-related mortality were also analyzed, Türkiye.

A total of 164 patients were included in this study. Seventy-three of the patients were female and 91 were male. There were 131 multiple myeloma, 23 Non-Hodgkin lymphoma, and 10 Hodgkin lymphoma. One-hundred thirty one (%80) received high-dose melphalan, 33 (%20) received BEAM. The median dose of CD34+ cells was similar in both groups (p=0,938). The duration of FN episode and length of hospital stay were significantly longer in the BEAM arm (p=0,001 and p=0,001). Invasive pulmonary aspergillosis was significantly more common in the BEAM arm (p=0,013). Of the bacteria isolated in culture, 29% (n=48) were gram-positive and 9% (n=14) were gram-negative. The most frequently isolated gram-positive bacteria were Staphylococcus epidermidis (n=29) and Staphylococcus aureus (n=7), while gram-negative bacteria were Klebsiella pneumoniae (n=5) and Pseudomonas aeruginosa (n=4). CRP and Pitt score were similar in bot groups (p=0,152 vs p=0,247). No significant difference in FN-related mortality was seen between the two arms (p=0,802), Türkiye.

Conclusion: The BEAM regimen significantly increased the risk of invasive pulmonary aspergillosis, length of hospital stay, and duration of febrile neutropenia. These results suggest that, particularly in lymphoma patients, the risks of FN should be taken into account when selecting the BEAM regimen, Türkiye.