BEAM Chemotherapy: Combination Chemotherapy Regimens

BEAM chemotherapy is an acronym representing a small family of combination chemotherapy regimens that are used chiefly as salvage regimens in the context of Hodgkin's lymphoma that includes dexa-BEAM and mini-BEAM. They are also used as salvage or preparative regimens, some prior to stem cell transplantations.

BEAM Chemotherapy

The drugs that are in the standard BEAM chemotherapy are:

BCNU (carmustine)
Etoposide
Ara-C (cytarabine)
Melphalan

BEAM chemotherapy is an intense, high-dose six-day regimen that normally unrolls like this:

Day 1: Carmustine (intravenous)
Days 2, 3, 4, 5: Etoposide (intravenous infusion); Cytarabine (intravenous infusion)
Day 6: Melphalan (intravenous)
Day 7: The patient undergoes the scheduled autologous stem cell transplantation

[Technically, the days should be numbered as a countdown; i.e. day 1= day -6, day 2=day -5 and so on until day 7, which equals day 0. I have done the opposite for easier understanding].

Dexa-BEAM Chemotherapy

Dexa-BEAM is an intense salvage chemotherapy regimen. The drugs used are as follows:

Dexamethasone
BCNU (carmustine)
Etoposide
Ara-C (cytarabine)
Melphalan

Dexa-BEAM chemotherapy unfolds as follows:

Cycle length: 28 days
Number of cycles: 2-4
Days 1-10: Dexamethasone (oral)
Day 2: BCNU (carmustine)
Day 3: Melphalan
Days 4-7: Etoposide (IV) & cytarabine (IV)

Mini-BEAM Chemotherapy

Mini-BEAM chemotherapy is a less dose-intense regimen that can be used as salvage chemotherapy or as a preparative regimen for a stem cell transplantation.

Cycle length: 28 days
Number of cycles: 2-4
Day 1: Carmustine
Days 2-5: Etoposide (IV); cytarabine (IV)
Day 6: Melphalan (IV)

If this regimen is used as a preparative regimen for a stem cell transplantation, the transplant would occur on the seventh day.

Sources

Boyiadzis, Michael M. et al. Hematology-Oncology Therapy. New York: McGraw Hill, Medical Publishing Division.

Perry, Michael C, Editor. Companion Handbook to the Chemotherapy Sourcebook. Baltimore; Williams & Wilkins.

Photo: Pexels

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