BEAM

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

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

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

You normally have BEAM chemotherapy before a stem cell transplant.

How you have BEAM chemotherapy

You have BEAM chemotherapy as cycles of treatment each lasting 3 to 4 weeks (21 to 28 days). How many cycles you have depends on how well it works. The treatment is repeated every 4 to 6 weeks.

You have all of the drugs into your bloodstream, usually through a long line either: a central line, a PICC line or a portacath. These are long, plastic tubes that give the drugs into a large vein in your chest. The tube stays in place throughout the course of your treatment.

During the treatment you can move around the ward even when the drip is going through. You have extra fluids (hydration) alongside the chemotherapy to help to keep your kidneys working properly.

Into your bloodstream

Apart from lomustine you have these drugs into your bloodstream, usually through a long line: a central line, a PICC line or a portacath.

These are long, plastic tubes that give the drugs into a large vein in your chest. The tube stays in place throughout the course of your treatment.

Taking your tablets or capsules

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.

Talk to your healthcare team before you stop taking or miss a dose of a cancer drug.

When you have treatment

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

You have blood tests before 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 get someone pregnant while you're having treatment and for a few months afterwards.

Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.

Breastfeeding

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

Blood clots

You are more at risk of developing a blood clot during treatment. Drink plenty of fluids and keep moving to help prevent clots.

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.

You can have:

• other vaccines, but they might not give you as much protection as usual
• the flu vaccine (as an injection)
• the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system recovers from treatment.

Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

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