ABVD Chemotherapy

What Is ABVD?

ABVD is the name of a chemotherapy treatment made up of the following drugs:

A – Doxorubicin (Adriamycin)
B – Bleomycin
V – Vinblastine
D – Dacarbazine (DTIC)

ABVD is normally used as first line treatment for the disease in the UK and other countries around the world.

How you have ABVD

You have ABVD drugs into your bloodstream (intravenously). You can have them through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have them through a central line, a portacath or a PICC line. These are long, plastic tubes that go directly into a large vein in your chest. The tube can stay in place throughout the course of treatment.

You usually have ABVD chemotherapy as cycles of treatment. Each cycle lasts 4 weeks. Depending on your needs, you may have from 4 to 6 cycles, taking 4 to 6 months in total.

You have each cycle of treatment in the following way: On the first day you have all 4 drugs mentioned above as injections or drips into your bloodstream. You then have a 2 week break. Then you have another dose of the same 4 drugs followed by another 2 week break. This completes one cycle of treatment and you then start another.

The side effects most associated with ABVD are listed below. Everybody is unique so do not presume as it is listed you will suffer from it:

Common side effects

More than 10 in every 100 people have one or more of the side effects listed below.

  • An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C. You will have regular blood tests to check your blood cell levels
  • Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
  • Bruising more easily due to a drop in platelets – you may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechia)
  • Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
  • A hypersensitivity reaction happens to up to half the people having bleomycin. This causes a high temperature (fever) and chills while you have the drug. If you have a high temperature the night after your treatment, tell your doctor or nurse when you go for your next dose
  • Skin reactions, such as reddening, darkening or thickening of the skin or nails or dry, peeling skin at the fingertips. You are most likely to develop these side effects 2 to 3 weeks after you start your treatment
  • Hair loss – almost everyone has complete head and body hair loss, which usually begins 2 to 5 weeks after the treatment starts. Your hair will grow back when the treatment ends
  • Loss of appetite
  • Feeling or being sick – you may have severe sickness, which may begin a few hours after treatment and last for a few days. It is usually possible to control it with anti sickness injections and tablets. If you still feel sick, tell your doctor or nurse because there are other anti sickness medicines you can try
  • A sore mouth – about 2 to 3 days after each treatment you may have red, sore skin in your mouth as well as mouth ulcers. This gradually clears up within a couple of weeks
  • Your urine may become pink or red for 1 or 2 days after treatment – this is due to the colour of one of the drugs and won’t harm you
  • Black or brown discoloration in the skin creases is particularly common in children
  • Sensitivity to sunlight – don’t sit out in the sun. Do make sure that you cover up or use sun block on exposed skin
  • Watery eyes occur in about 1 in 4 people with doxorubicin (25%). This may last for several days after the beginning of each treatment
  • Women may stop having periods (amenorrhoea) but this may only be temporary
  • Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment.

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these effects.

  • Inflammation around the drip site – if you notice any signs of redness, swelling or leaking at your drip site, tell your nurse straight away
  • An allergic reaction happens to 3 people out of 100 who have doxorubicin (3%). You may have a sudden rash of pink, itchy bumps on your skin and a reddening of the skin along the veins. It should clear up within a few days
  • Reddening of the skin may occur in areas where you have had radiotherapy in the past. The skin may also get dry and flaky and feel sore and hot. This goes away on its own but keep affected areas out of the sun
  • Damage to heart muscle may happen. This is usually temporary but for a small number of people may be permanent. Your doctor will check your heart before and after your treatment
  • Diarrhoea – drink plenty of fluids. If the diarrhoea becomes severe or continues for more than 3 days tell your doctor or nurse because you could get dehydrated
  • Constipation can be a problem but this is usually well controlled with laxatives. Tell your doctor or nurse if you are constipated for more than 3 days
  • Taste changes – food may taste metallic
  • Nails may become darker and white lines may appear on them
  • Fever and chills
  • Numbness or tingling in fingers and toes can cause difficulty with fiddly things such as doing up buttons. This starts within a few days or weeks. It usually goes within a few months of finishing treatment
  • Inflammation of the lungs occurs in about 1 in 10 patients (10%) but it is more common in people over 70. You will have lung tests before and during treatment. Tell your doctor or nurse if you develop a dry cough or breathlessness, especially in cold weather
  • Flu like symptoms may occur for a week after treatment in about 1 in 10 people (10%). You may have a high temperature (fever), chills, and muscle and joint aches, or weakness
  • Sore eyes happen in some people

Rare side effects

Fewer than 1 in 100 people have these effects:

  • Depression
  • Headaches
  • Jaw pain
  • High blood pressure
  • A fast heart rate
  • Difficulty emptying your bladder
  • Dizziness and changes in your vision
  • An allergic reaction to vinblastine – tell your doctor or nurse straight away if soon after having vinblastine you have a sudden cough, wheezing or difficulty breathing

This article is based on on information gained from Cancer Reserch website here. I will be updating the content and adding to it shortly, so I hope I am not upsetting anyone by using the info as a starting point! (If I am please message me!)