carmustine + cytarabine + etoposide + melphalan

BEAM is a chemotherapy regimen consisting of four drugs: carmustine (also known as BCNU), cytarabine (also known as Ara-C or cytosine arabinoside), etoposide, and melphalan (also known as Alkeran). This combination is primarily used as a conditioning regimen before autologous or allogeneic stem cell transplantation in patients with lymphoma, including Hodgkin lymphoma and non-Hodgkin lymphoma. Each component has a distinct mechanism of action:

• Carmustine is an alkylating agent that cross-links DNA and RNA, inhibiting replication and transcription.
• Cytarabine is an antimetabolite that inhibits DNA synthesis by acting as a cytosine analog.
• Etoposide inhibits topoisomerase II, leading to DNA strand breaks.
• Melphalan is another alkylating agent that cross-links DNA strands.

The regimen aims to eradicate malignant cells and suppress the immune system prior to stem cell transplantation. It is considered standard for high-dose chemotherapy in this setting due to its efficacy and tolerability profile.