BEACOPP
Bleomycin, Etoposide, Adriamycin, Cyclophosphamide, Vincristine, Procarbazine, and Prednisone
Escalated BEACOPP is used for advanced Hodgkin lymphoma when ABVD is insufficient. It is more intensive with a higher side effect burden.
21 days
Cycle length
6 cycles
Typical course
6
Side effects tracked
Common Side Effects
Severe neutropenia
days 7–14 every cycle
Tip: G-CSF injections are standard with BEACOPP. Fever is a medical emergency — go to ER if temperature is over 100.4°F.
Nausea and vomiting
days 1–5
Tip: BEACOPP causes significant nausea. Multiple anti-nausea medications are prescribed — take them all as scheduled.
Fatigue
severe and cumulative
Tip: Expect significant fatigue throughout BEACOPP treatment. Many patients require help with daily activities.
Hair loss
weeks 2–3 of first cycle
Tip: Complete hair loss expected. Temporary.
Lung toxicity (bleomycin)
cumulative
Tip: Report any new shortness of breath or cough immediately.
Fertility effects
during treatment
Tip: BEACOPP carries a higher risk of infertility than ABVD. Discuss fertility preservation with your team before starting if relevant.
Critical Days in the Cycle
Day 7 — Nadir Approaching
Watch for
- •Rising temperature
- •Fatigue increase
When to call:
Any fever ≥100.4°F — go to the ER immediately, do not wait for a callback.
Day 10 — Nadir
Watch for
- •Fever
- •Infection
- •Bleeding
When to call:
Fever ≥100.4°F — go to the ER immediately, do not wait for a callback. Neutropenic fever is a medical emergency.
Frequently Asked Questions
Why is BEACOPP used instead of ABVD for some patients?
BEACOPP has a higher cure rate for advanced-stage Hodgkin lymphoma, but with more severe side effects. Oncologists weigh the benefit of better cancer control against the higher toxicity for each patient.
When should I call the oncology team?
For fever ≥100.4°F — go to the ER immediately, do not wait for a callback. Call the team for: any new shortness of breath, severe vomiting, or unusual bleeding.
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