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BEAM

Find out what BEAM chemotherapy is, how you have it and other important information about having BEAM chemotherapy.

BEAM is the name of a combination of chemotherapy drugs that includes: 

  • B – Carmustine (BiCNU) 
  • E – Etoposide
  • A – Cytarabine (Ara-C, cytosine arabinoside)
  • M – Melphalan

BEAM is a treatment for Hodgkin lymphoma and non Hodgkin lymphoma. 

You normally have BEAM chemotherapy before a stem cell transplant.

Lomustine

When Lomustine is used instead of Carmustine, the combination is called LEAM. 

Lomustine comes as blue capsules. You should keep them in a tightly closed container and out of the reach of children. You take the capsules on an empty stomach at bedtime. They should be swallowed whole with plenty of water. Your doctor will tell you the dose and when to take them.

Variations of BEAM and LEAM

Mini-BEAM

Mini-BEAM uses the same drugs as BEAM chemotherapy regimen but at lower doses.

Dexa-BEAM

This regimen of chemotherapy is the same as mini-BEAM with the steroid dexamethasone added to it.

Mini- BEAM and Dexa-BEAM are given as cycles of treatment.

Each cycle is 21 or 28 days. 

How you have BEAM

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You may need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Taking your tablets or capsules

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

When you have treatment

Day 1
  • carmustine as a drip into your bloodstream over 2 hours
Day 2 to Day 5
  • cytarabine as a drip into your bloodstream over 30 minutes twice a day
  • etoposide as a drip into your bloodstream over 2 hours
Day 6
  • melphalan as a drip into your bloodstream over 15 to 30 minutes

About 24 hours after the melphalan you have your stem cells. 

You usually stay in hospital during the 7 days of treatment and for 2 to 3 weeks afterwards. This completes one cycle of treatment. 

You may hear your doctors name the days slightly differently. So that the first day of treatment is called minus 7 and they count down to the day you have the stem cells on Day 0.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Loss of fertility

You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Breastfeeding

Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Last reviewed: 
26 Jun 2017
  • British National Formulary
    Accessed June 2017

  • Electronic Medicines Compendium 
    Accessed June 2017

  • Influenza vaccines in immunosuppressed adults with cancer
    Noa Eliakim-Raz and others
    Cochrane Database of systematic reviews, 29 October 2013

  • Long-term follow-up in patients treated with Mini-BEAM as salvage therapy for relapsed or refractory Hodgkin's disease.
    A Martin and others
    British Journal of Haematology, 2001, Volume 113, Issue 1

  • Comparison of BEAM vs. LEAM regimen in autologous transplant for lymphoma at AIIMS

    Sharma, A and others (2013) 

    Springer Plus , 2:489

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