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Busulfan + etoposide + cytarabine + melphalan (BuEAM) is a high-dose combination chemotherapy regimen used primarily as a conditioning treatment before autologous stem cell transplantation (ASCT), especially in patients with lymphomas such as non-Hodgkin lymphoma and peripheral T-cell lymphomas. The regimen replaces carmustine in the standard BEAM protocol with intravenous busulfan. Each component has a distinct mechanism of action: - Busulfan is an alkylating agent that crosslinks DNA, leading to cell death. - Etoposide inhibits topoisomerase II, causing DNA strand breaks. - Cytarabine is an antimetabolite that inhibits DNA synthesis by acting as a cytidine analog. - Melphalan is another alkylating agent that crosslinks DNA and RNA. The combination aims to maximize myeloablation and anti-tumor activity prior to stem cell rescue. Clinical studies have shown BuEAM to be effective and generally well tolerated for ASCT conditioning in various lymphoma subtypes[1][2][8].
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