What is the BEAM regimen for 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

High-dose therapy, which requires hematopoietic stem cell support for recovery, is given according to the BEAM regimen. Different schedules for BEAM exist that vary primarily in the dose of etoposide administered. The following is the version used by Schmitz et al in a key randomized, prospective clinical trial [7] :

  • BCNU 300 mg/m 2, day –7
  • Etoposide 150 mg/m 2, every 12 hours, total of 8 doses, days –7 to –4
  • Cytarabine 200 mg/m 2, every 12 hours, total of 8 doses, days –7 to –4
  • Melphalan 140 mg/m 2, day –3

Following this chemotherapy regimen, autologous hematopoietic stem cells are administered on day 0.

Brentuximab vedotin is indicated as consolidation therapy following autologous hematopoietic stem cell transplantation (HSCT) in patients with classic Hodgkin lymphoma who are at at high risk of relapse or progression. Approval for this indication was based on the AETHERA clinical trial, in which median progression-free survival was 42.9 months in the brentuximab group versus 24.1 months in the placebo group, a statistically significant improvement of 18.8 months (P=0.001). [64]

The regimen is initiated 4-6 weeks after autologous HSCT as 1.8 mg/kg IV (not to exceed 180 mg/dose) infused over 30 minutes three times weekly for up to 16 cycles, or until disease progression or unacceptable toxicity. [24]


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