What is the BEACOPP regimen for treatment of Hodgkin lymphoma (Hodgkin disease)?

Updated: Sep 12, 2018
  • Author: Bradley W Lash, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The BEACOPP regimen was developed in Germany and is the default standard regimen there. [57] A dose-intensified version of BEACOPP (escalated BEACOPP), with higher doses of etoposide, doxorubicin, and cyclophosphamide and the addition of granulocyte colony-stimulating factor (G-CSF) for neutrophil support, has also been developed and may be useful for unfavorable, advanced-stage Hodgkin lymphoma. However, escalated BEACOPP is associated with greater hematologic toxicity and a higher incidence of secondary malignancies, including acute myelogenous leukemia (AML).

A study by Viviani et al demonstrated that BEACOPP produced better initial outcomes in patients with advanced Hodgkin lymphoma than treatment with ABVD but found no significant long-term differences between the regimens. [58] A meta-analysis by Bauer et al found that patients aged 16-60 years with early unfavorable or advanced stage disease benefited from escalated BEACOPP in terms of progression-free survival; however, no significant difference was noted in overall survival. [59]

More recently, a randomized comparison study by Mounier et al in 150 low-risk patients with an International Prognostic Score (IPS) of 0-2, found that progression or relapses were more frequent with ABVD than BEACOPP (17 versus 5 patients, respectively). [60] In contrast, a randomized comparison study by Carde et al in 549 patients with high-risk stage III-IV Hodgkin lymphoma, and reported similar rates of event-free and overall survival with ABVD and BEACOPP; these authors stressed the importance of considering treatment burden, immediate and late toxicities, and associated costs when selecting a regimen. [61]


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