Mini-BEAM as salvage therapy for relapsed or refractory Hodgkin's disease before intensive therapy and autologous bone marrow transplantation

J Clin Oncol. 1995 Feb;13(2):396-402. doi: 10.1200/JCO.1995.13.2.396.


Purpose: To evaluate the efficacy of carmustine (BCNU), etoposide, cytarabine (Ara-C), and melphalan (mini-BEAM) as salvage therapy in patients with relapsed or refractory Hodgkin's disease who were potentially eligible to undergo intensive therapy and autologous bone marrow transplantation (ABMT).

Patients and methods: Forty-four patients with refractory or relapsed Hodgkin's disease after front-line combination chemotherapy referred for consideration of ABMT were treated with mini-BEAM (BCNU 60 mg/m2 on day 1, etoposide 75 mg/m2 on days 2 to 5, Ara-C 100 mg/m2 twice per day on days 2 to 5, and melphalan 30 mg/m2 on day 6) to maximum response. Eleven patients were refractory to primary chemotherapy. Twenty-three patients were treated in first relapse and 10 in second or subsequent relapse; 21 received mini-BEAM as their first salvage regimen. Patients were restaged to determine disease status immediately before intensive therapy and transplant.

Results: The overall response rate was 84% (exact 95% confidence interval [CI], 70% to 92%), with a complete response (CR) rate of 32% (95% CI, 20% to 47%) and a partial response (PR) rate of 52%. No treatment-related deaths were observed. Myelosuppression was the major toxicity. Almost all patients required platelet transfusions. Eighty-four percent were given RBC transfusions, and 54% required intravenous antibiotics for fever while neutropenic.

Conclusion: Mini-BEAM is a safe and effective regimen for treatment of refractory or relapsed Hodgkin's disease. Further studies are required to determine if responding patients have improved disease-free survival (DFS) after intensive therapy and ABMT.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bone Marrow Transplantation*
  • Carmustine / adverse effects
  • Carmustine / therapeutic use
  • Confidence Intervals
  • Critical Care
  • Cytarabine / adverse effects
  • Cytarabine / therapeutic use
  • Erythrocyte Transfusion
  • Female
  • Follow-Up Studies
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / radiotherapy
  • Hodgkin Disease / therapy
  • Humans
  • Male
  • Melphalan / adverse effects
  • Melphalan / therapeutic use
  • Middle Aged
  • Neutropenia / chemically induced
  • Platelet Transfusion
  • Podophyllotoxin / adverse effects
  • Podophyllotoxin / therapeutic use
  • Preoperative Care
  • Prognosis
  • Recurrence
  • Salvage Therapy*
  • Time Factors


  • Cytarabine
  • Podophyllotoxin
  • Melphalan
  • Carmustine

Supplementary concepts

  • BEAM protocol