Overview:
- BEACOPP is an intensive chemotherapy regimen used for advanced-stage classical Hodgkin lymphoma (cHL), especially in young, high-risk patients.
- Two main versions:
BEACOPP Components:
| Drug | Role / Mechanism |
|---|---|
| B – Bleomycin | Antitumor antibiotic; causes DNA strand breaks |
| E – Etoposide | Topoisomerase II inhibitor |
| A – Doxorubicin (Adriamycin) | Anthracycline; intercalates DNA |
| C – Cyclophosphamide | Alkylating agent |
| O – Vincristine (Oncovin) or Vinblastine | Vinca alkaloid (mitotic inhibitor) |
| P – Procarbazine | Alkylating agent |
| P – Prednisone | Corticosteroid |
Note: Vincristine is sometimes substituted with vinblastine in some versions.
Indication:
- Advanced-stage (Stage III–IV) classical Hodgkin lymphoma, especially in young, fit, high-risk patients
- Also used when poor prognostic factors are present (e.g., IPS ≥3)
Dosing Schedule:
- Escalated BEACOPP: 21-day cycles (x 4–6 cycles), with dose-intensification and G-CSF support
- Standard BEACOPP: Less intensive version, lower toxicity
Key Toxicities:
- Severe myelosuppression → neutropenia, anemia, thrombocytopenia
- Febrile neutropenia (G-CSF is mandatory)
- Pulmonary toxicity (bleomycin)
- Fertility impairment (alkylating agents: cyclophosphamide, procarbazine)
- Cardiotoxicity (doxorubicin)
- Nausea/vomiting (highly emetogenic)
Pharmacist Considerations:
- Mandatory G-CSF for escalated BEACOPP
- Monitor PFTs (bleomycin), LVEF (doxorubicin)
- Counsel on fertility preservation
- Supportive care: antiemetics, infection prophylaxis
- Monitor for tumor lysis syndrome, especially in bulky disease
Synonyms
BEACOPP