ABVD

ABVD is a

• hydroxydaunorubicin, designated as H in CHOP
  )
• Bleomycin
• Vinblastine
• MOPP and in COPP
  )

As of 2007, ABVD is widely used as the initial chemotherapy treatment for newly diagnosed Hodgkin lymphoma.^[citation needed] It has been the most effective and least toxic chemotherapy regimen available for treating early-stage Hodgkin Lymphoma.^[1] The other chemotherapy regimens that are widely used in this setting is the Stanford V and BEACOPP regimens.^{[citation needed]}

Administration

One cycle of ABVD chemotherapy is typically given over 4 weeks in two doses, with the first on day 1 and the second dose on day 15. All four of the chemotherapy drugs are given

Dosages above are given according to the body surface area dosing model.

The number of cycles given depends upon the stage of the disease and how well the patient tolerates chemotherapy. Doses may be delayed because of neutropenia, thrombocytopenia, or other side effects.^{[citation needed]}

A

Side effects of ABVD can be divided into acute (those occurring while receiving chemotherapy) and delayed (those occurring months to years after completion of chemotherapy). Delayed side effects have assumed particular importance because many patients treated for Hodgkin lymphoma are cured and can expect long lives after completion of chemotherapy.^[citation needed]

Acute side effects

• Hair loss, or
  alopecia
  , is a fairly common but not universal side effect of ABVD. Hair that is lost returns in the months after completion of chemotherapy.
• Nausea and vomiting can occur with ABVD, although treatments for chemotherapy-induced nausea and vomiting have improved substantially (see Supportive care below).
• Low blood counts, or
  growth factors are sometimes used to prevent this (see Supportive care below). Blood counts are checked frequently while receiving chemotherapy. Any fever or sign of infection that develops needs to be promptly evaluated; severe infections can develop rapidly in a person with a low white blood cell
  count due to chemotherapy.
• Allergic reactions to bleomycin can occur. A small test dose of bleomycin is often given prior to the first round of ABVD to screen for patients who may be allergic.
• Neuropathy: Chemotherapy-induced peripheral neuropathy, a progressive and enduring tingling numbness, intense pain, and hypersensitivity to cold, beginning in the hands and feet and sometimes involving the arms and legs.^[3]

Delayed side effects

• Infertility is probably infrequent with ABVD. Several studies have suggested that, while
  oncologist
  before beginning ABVD therapy.
• Pulmonary toxicity, or
  Pulmonary function tests are often used to assess for bleomycin-related damage to the lungs. One study found bleomycin lung damage in 18% of patients receiving ABVD for Hodgkin disease.^[7] Retrospective analyses have questioned whether bleomycin is necessary at all;^[8]
  however, at this point it remains a standard part of ABVD.
• Cardiac toxicity, or
  adriamycin
  . The occurrence of adriamycin-related cardiac toxicity is related to the total lifetime dose of adriamycin, and increases sharply in people who receive a cumulative dose of more than 400 mg/m². Almost all patients treated with ABVD receive less than this dose (for 6 cycles of ABVD, the cumulative adriamycin dose is 300 mg/m²); therefore, adriamycin-related cardiac toxicity is very uncommon with ABVD.
• Secondary malignancies. Patients cured of Hodgkin lymphoma remain at increased risk of developing other (secondary) cancers. Treatment-related
  preventive care
  after completion of treatment. Radiation and chemotherapy probably both play a role in the development of these secondary malignancies; the exact contribution of chemotherapy such as ABVD can be difficult to tease out.

Supportive care

Supportive care refers to efforts to prevent or treat side effects of ABVD chemotherapy, and to help people get through the chemotherapy with the least possible discomfort.

Antiemetics

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Significant advances in antiemetic, or anti-nausea, medications have been made in the beginning of the 21st century. Patients will often receive a combination of 5-HT₃ receptor antagonists (e.g. ondansetron), corticosteroids, and benzodiazepines before chemotherapy to prevent nausea. These medicines are also effective after nausea develops, as are phenothiazines. Each person's sensitivity to nausea and vomiting varies. Overall, while patients often experience some mild to moderate nausea, severe nausea or vomiting are uncommon with ABVD.

Emetogenicity is high.

Ensure that patients have sufficient antiemetics for breakthrough emesis with Metoclopramide 10 mg to 20 mg every 4 to 6 hours when necessary OR Prochlorperazine 10 mg PO or 12.5 mg IV every 4 to 6 hours when necessary.^[11]

Growth factors

Blood growth factors are medicines that stimulate the

Prior to the mid-1960s, advanced-stage Hodgkin disease was treated with single-agent

Scientists analyzed samples of ovarian tissue donated by eight women who had undergone ABVD chemotherapy, alongside tissue from fifteen healthy women.^[citation needed]

They found that the tissue from the cancer patients treated with ABVD had between four and 10 times more eggs compared with tissue from women who had received a different chemotherapy, or healthy women of a similar age. The ovarian tissue was in healthy condition, appearing similar to tissue from young women's ovaries.^{[citation needed]}

Although the eggs are in an immature state, the scientists are trying to discover how they were created, then work out a way to bring them to maturity. It is unclear if the eggs in their current form would be functional.^[19]

See also

• BEACOPP
• CHOP
• Stanford V
• Hodgkin lymphoma

References