OnCo

Escalated BEACOPP

Checked 2026-09-09

Advanced-stage classical Hodgkin lymphoma in fit patients under 60, PET-adapted to 4-6 cycles

Also called BEACOPP, BEACOPPesc, eBEACOPP.

One cycle

every 21 days × 4-6 · about 12 weeks in total
178141521Bleomycin: 10 mg/m², IntravenousBleomycinEtoposide: 200 mg/m², IntravenousEtoposideDoxorubicin: 35 mg/m², IntravenousDoxorubicinCyclophosphamide: 1,250 mg/m², IntravenousCyclophosphamideVincristine: 1.4 mg/m² (maximum 2 mg), IntravenousVincristineProcarbazine: 100 mg/m² once daily, OralProcarbazinePrednisone: 40 mg/m² once daily, OralPrednisone
21-day cycle × 4-6 (about 12 weeks)IntravenousOral Daily oral course

Components

DrugDoseRouteDays
Bleomycin
Glycopeptide antibiotic (DNA-cleaving)
10 mg/m²IVD8
Etoposide
Topoisomerase II inhibitor (podophyllotoxin derivative)
200 mg/m²IVD1-3
Doxorubicin
Cytotoxic chemotherapy (anthracycline)
35 mg/m²IVD1
Cyclophosphamide
Alkylating agent (oxazaphosphorine prodrug)
1,250 mg/m²IVD1
Vincristine
Vinca alkaloid (microtubule inhibitor)
1.4 mg/m² (maximum 2 mg)IVD8
Procarbazine
Alkylating-like methylhydrazine derivative
100 mg/m² once dailyOralD1-7
Prednisone
Glucocorticoid
40 mg/m² once dailyOralD1-14
Cycles
4-6
21-day cycle
Emetogenicity
High (>90%)
G-CSF
Built into the protocol

Notes

  • Higher cure rates than ABVD in advanced disease at the cost of more infertility and second cancers; HD18 showed 4 cycles suffice after a negative interim PET.
  • The BrECADD variant replaces bleomycin and vincristine with brentuximab vedotin and dacarbazine (HD21).

Used in

Source

Engert (GHSG HD15), Lancet 2012

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.

Other regimens for these cancers