Thursday, October 7, 2010

7th - Learning About Chemo

With almost all of my test results back, with the exception of the bone marrow biopsy, it is time to start seriously planning for chemotherapy.  As I have mentioned previously, the standard of care in the US for Hodgkin's Lymphoma is ABVD chemotherapy.  For me, it will be a 6-8 month regime, with treatments given every two weeks.

In order to learn more about ABVD and the potential side effects, Stuart and I spent the better part of the morning with Lindsay D. Griffin, Oncology RN extraordinaire.  Lindsay was great and gave us a lot of detail, which I'll summarize for those of you who are interested.

ABVD is an acronym using the first letter of each of the four chemotherapy drugs used.

A = Adriamycin/Doxorubicin (a.k.a. "The Red Devil")

The red drug, Adriamycin, is usually given first.  It is administered via a slow IV push over 10 minutes or so.  Common side effects include:
  • Reduced blood counts, possibly leading to fever, chills, etc.
  • Hair loss
  • Nausea and vomiting
  • Discolored (red) urine - no shock here
I should have this drug in relatively low doses, although in higher doses it can cause heart problems.

B = Bleomycin/Blenoxane (a.k.a. Bleo)


Bleo is a clear fluid given via IV push, or mixed in 100ml normal saline solution and infused over 10 minutes or so.  Common side effects include:
  • Fever and chills, which may occur after treatment
  • Skin and nail changes, typically involving brown, yellow or pink discoloration and brittle texture.
More rarely, Bleo can case changes in your lung tissue, including shortness of breath.  It also contributes to hair loss.  In some cases there is an allergic reaction to Bleo, so prior to your first chemo treatment you will receive a "test dose".

V = Vinblastine/Velban/VLB

Vinblastine is another clear fluid given via IV injection/infusion.  Common side effects include:
  • Nerve changes or muscle cramping, which may occur within two weeks of the first treatment or after several doses have been given.  Numbness, tingling or burning in the fingers and toes is common.
  • Constipation
Less typically, reduced blood counts, hair loss and increased blood pressure may occur.

D = Dacarbazine/DTIC

Dacarbazine is a clear liquid or may have a faint yellow tint.  It is typically mixed in 250ml or more of D5W and infused over 30 minutes or longer (more of a drip).  Common side effects include:
  • Flu-like syndrome
  • Reduced blood counts
  • Nausea and vomiting
Less commonly, it may promote hair loss.  Uh-oh!

That is ABVD...3-5 hours and you are done and on your way.