Most Hodgkin's patients received MOPP, ABVD, a combination or MOPP/ABV. Although there are other chemotherapy treatments, such as Stanford V and British MOPP, these are the most common. If anyone has the patient information sheets about the other combinations and their drugs I would like to add them to these pages. Please see the Suggestions section for my address.
In this section I will list the drugs, their alternate names, and common side effects. If you have a question that is not answered here, please consult with your doctor. If you would also e-mail me the question so that I might improve the page I would appreciate it.
I have not included side effects such as low blood counts and hair loss under individual drugs because they are effects that all of the drugs cause and there is no sense in repeating the information over and over. Please talk to your doctor about blood count concerns (you'll get used to having low counts) and see the 'hair loss' section of the Side Effects pages for more information.
MOPP is made up of 4 drugs. Two by IV and two pills taken orally for a number a days. These drugs are:
Mustargen is also known as MSD, Mechlorethamine, and Nitrogen Mustard. Yes, you read that last one correctly, Nitrogen Mustard. The same drug they used to kill people in World War I is used to save your life!
This drug can cause irritation to the vein used in the IV. Soak a washcloth in hot water and apply it to the vein as often as necessary when you get home. Another alternative is a heating pad. The heating pad will work, but the vein really likes the moisture of the washcloth. A combination of the two may work best throughout the day.
As with almost all chemo drugs this can cause nausea, usually 4-5 hours after treatment. ROOM TEMPERATURE 7-Up, rather than cold, is your best bet. If you drink it cold it should be flat. Also be sure to take the Zofran or Compazine (more info under the 'Nausea' side effect section).
Finally, the last possible immediate effect is loss of appetite. Generally I find this is more than taken care of by the Prednisone, but if not, try eating smaller meals but more of them.
MOPP is a leading cause of sterility in men, although the effects on women do not seem as strong. Women should be sure to tell their doctor of any change in their menstrual period. If you have any concerns about fertility be sure to discuss them with your doctor *before* you start treatment.
Oncovin is also called Vincristine or VCR and is given by IV.
This drug is the one that can cause tingling in your fingers and toes. In most people this will go away with time. Usually six weeks after treatment ends. Be sure to tell your doctor when you start to have the tingling and how strong it is, and be careful about using hot water bottles and such as you may not be able to tell if you are burning yourself. It is also recommended that women not wear high heeled shoes, but I think that that is because of the swelling your feet will already be feeling in treatment. I'm not sure why else they would say that, but trust me it is good advice. I learned! You may also feel dizziness when you have this drug. When I first started treatment I got up quickly, ran up the stairs to answer the door and promptly passed out. Very embarrassing! Get up slowly to avoid these things happening to you.
Finally, this drug can cause constipation. Never a pleasant topic I know. Be sure to drink A LOT of water while on these drugs and consult with a dietitian (there should be one in your oncologists office) and your doctor about what to do for this problem. There *are* things you can do.
Procarbazine (or Matulane) is easily one of the most annoying drugs you will take. That is because of the food restrictions involved with it. All of the things you will see under food restrictions have a common chemical called Tyramine that your stomach cannot digest while you are on the drug and will cause you sever pain if you eat them in any quantity. I forgot about the restrictions one day when I was having a sub craving, so I went down to the Mr. Goodcents in town and got myself a ham, salami and provolone. I was in pain for the next 5 days. PLEASE print the food restrictions and keep them on you while you are taking the drug. Also remember that some medications include alcohol which is banned while on this drug.
Other than the food restrictions it isn't difficult. You will take this drug at home for about 7 days. You might get some of the usual nausea, so you may take your anti-nausea drugs longer on MOPP than on ABVD. It can also cause diarrhea, which you need to tell your doctor about.
You may feel some joint or muscle pain, and this is usually taken care of with 2 Tylenol every few hours. Remember to talk to your doctor before using aspirin or Motrin since they are blood thinners and the last thing you need now is a blood thinner. In fact, Procarbazine reduces the number of red blood cells you need for clotting. You should avoid dental procedures while on this medication because of the risk of bleeding and infection. Your ability to fight infection is reduced on this medication and you should avoid those who are sick as well as crowds.
You will also be more sensitive to sunlight on this drug and you should be careful and wear sunscreen if you are going to be outside or in a car for any length of time.
Finally, if it upsets your stomach you will want to talk to your doctor about getting Zantac (more on that under Prednisone).
Prednisone is taken by mouth and produces more complaints than any other drug. This is, of course, because anti-nausea drugs have pretty much wiped out the previous winner in this category! =)
One thing to be careful of on prednisone is that it can 'mask the signs of infection' so you have to be careful when you are on it about avoiding situations in which you could be infected. Prednisone will also raise your blood pressure, so you will want to avoid stressful situations.
Prednisone also causes that swelling I spoke of earlier, and you will find you retain a lot of water. Your face will become round (sometimes called 'moonface') and your ankles will seem to double in size. This does go away but it can be disconcerting when your shoes don't fit.
Because prednisone is very hard on the gastrointestinal system, most people will be put on Zantac or a similar drug. I have a history of ulcers and so I have very biased opinions (I think that Tagamet is crap and not worth a penny for one), but I think that Zantac is a miracle drug. With the prednisone I took 150mg of Zantac twice a day while on the prednisone and two weeks after as well. When doing that I never had a problem. If I stopped taking the Zantac early my stomach revolted. Your mileage may vary.
Prednisone can cause mood swings. If you find yourself doing and saying things that 'just aren't me' talk to your doctor and she may be able to change your dosage. In my case, not only did I have mood swings, but the prednisone kept me up all night! Eventually we lowered the dosage per day so that I took it for more days, and I also took it all by lunchtime so that I could sleep at night. I still took Tylenol PM to help me sleep on some days I took prednisone. Do what you need to do to stay sane!
Finally, remember how they told you you would lose weight on chemo? They lied. This drug is nasty. It makes you hungry when you are so tired you can't exercise. By my experience and the polls I've taken, the average weight gain on prednisone is 30 pounds over 6 months. Good luck!
ABVD is made up of 4 drugs. Three are given by IV push and 1 is given by a drip. The nice thing is that you don't have to worry about food restrictions or remember to take any pills. It also makes you very tired. I used to sleep up to 17 hours a day for 2-3 days after ABVD treatments. DO NOT DRIVE after an ABVD treatment.
Adriamycin (aka Adria, Doxorubicin, Hydroxyl Daunorubcin) is sometimes known as 'the big red one', 'cherry kool-aid' and other fun names.
You will definitely know when they are pushing the Adria because it is a deep red. I knew that before my first ABVD treatment and it helped me to not freak out. Otherwise I think I would have as all our other drugs are clear (some patients have drugs that are bright blue among other colors). You will see how quickly the adria passes through you, because it turns your urine an orange color. This is nothing to be concerned with, though it is a bit odd to see! For some patients this can last for several days, but for most it will be less than one.
Another fun thing is that Adria can cause diarrhea. Normally you won't have to worry about this because most of the other drugs cause constipation. THAT you will probably have to deal with.
Other than the standard possibilities of mouth sores and nausea, there isn't much to worry about except this: Adria can cause heart damage. This is not a reason to refuse using it, remember that if you die of Hodgkin's your heart won't matter much. Use the Adria, but notify your doctor if you have chest pain, shortness of breath, swelling in your feet or irregular heartbeats. Your doctor will monitor you and if s/he feels it necessary will change drugs. More than likely you won't have a problem.
Bleo is also known as: Blenoxane, Bleomycin Sulfate.
Some people have an allergic reaction to Bleo, so they will give you a test dose to make sure that you won't. For me, this meant that I sat in the chair with an IV for 5 hours on my first treatment (bring a friend and a good book!). They gave me the test dose and waited 5 hours. For others they give an injection into an arm or other place to see what the reaction is. Be sure to notify your doctor at any time if you have fever, chills, wheezing, confusion or light-headedness.
Bleo can cause fever an chills, so most doctors will give you Tylenol before your IV and also tell you to take it at home if you have a fever. I took my temperature every two hours to be sure.
Bleo can cause lung damage so your doctor may have you take a pulmonary functions test to make sure that you are ok. I had mine after treatment and there was only slight damage. I don't notice a difference most of the time. I have noticed an increase in asthma problems though. If you develop a cough, shortness of breath, or chest pain tell your doctor as soon as possible.
Velban is also commonly known as Vincristine. This drug is given as a drip.
Velban has to be given very slowly. An advantage to getting a port is that it can be given faster and you avoid 'vein pain'. Velban can hurt going into the vein, but it helps if you put a very cold washcloth over the area while it is being injected. When you get home, however, you will want to apply WARM moist packs to the area. A heating pad will work, but not as well as a warm washcloth. You may notice that your vein looks like a red streak up and down your arm. This is where you will want to apply the pack. Your chemo nurse also may not be able to use that vein again. Ask them about ports.
Velban causes that constipation we mentioned earlier. Vegetables, water, and some people swear by laxatives, will help. Drink at least a liter of water a day during chemo.
Another side effect from Velban is tingling and numbness in your fingers and toes. This should end about 6 weeks after treatment is over. Although nothing to worry about, tell your doctor about this symptom and also if you find yourself dropping things or being clumsy. You should also shouldn't wear high heels or slingback shoes as you may trip (not to mention when your feet swell it'll make everything worse, trust me). In addition, get up slowly, don't run, and be careful with hot water and other heat elements. You may have impaired ability to tell temperature and might burn yourself.
This drug is also known as Dacarbazine or ICDT.
This drug is the least important of the ABVD regimen, and in fact some doctors don't bother with it at all. If you hear of a shortage, don't worry about it.
One side effect with DTIC that is different than in the other drugs is the possibility of a flushed face. In me it looked like a pink rash on one cheek. It was nothing to worry about and went away in a couple days, but my doctor did want to keep track of such things.
Other than the standard side effects, the only worry with it is liver functions. Your doctor will monitor your liver function through blood tests (LDH factor). Please be sure to clear ALL over the counter medications, alcohol and so forth with your doctor as DTIC in combination with these things can cause liver damage.
Copyright 1997. Last updated July 4, 1997.