Hodgkin's Chemotherapy - ABVD

Recommended Books:

Regimen Drugs:

The following are the drugs used in the regimen.  Select a drug to see pertinent information:

• Adriamycin (generic name Doxorubicin)
• Bleomycin (common brand name: blenoxane)
• Vinblastine (common brand names: velban, velsar, velbe)
• Dacarbazine (common brand name: DTIC, DTIC-Dome)

Before starting the regimen:

Read information on each drug.  You should discuss your treatment thoroughly with your doctor/medical team.  Items to mention include if you are pregnant, have a history of heart or lung problems, or if you smoke.  If you have had major medical problems in the past or have a family history of problems these should be discussed also.

This regimen may cause permanent sterility (shown to be less severe than MOPP though).  You may want to discuss with your medical team options such as sperm banking or egg harvesting.  The harvesting of ova is a rapidly evolving field - please ask about the latest information if you wish to pursue this option.

Administration:

ABVD is typically administered in cycles of 4 weeks.  Two treatments will be in each cycle, two weeks apart.  A common treatment regimen is for 6 cycles which would be 12 treatments spaced two weeks apart. The exact number of cycles given is dependent on the treatment prescribed by the medical team. 

Adriamycin, Bleomycin, and Vinblastine are usually given as follows: you have a saline intravenous drip and the drugs are injected into the IV tube while receiving the saline).  Dacarbazine is given commonly by a chemotherapy pump which can administer a fixed rate of the drug.  If burning or pain occurs from a drug you may want to ask the administrator (often a nurse trained in chemotherapy administration) to slow down the drug infusion.  This may happen especially with vinblastine and/or dacarbazine.  The use of a port or catheter will allow doses to be given quicker with less chance of irritation.

The doses are determined by square meters of body area.  So you don't have to measure every nook they have tables - the body area is approximated from weight and height.  Please refer to qualified medical personnel for exact dosing.

Drugs that are often given in the same sitting are:

• Zofran or Kytril - for nausea
• Decadron - a steroid, also for nausea (ask your medical team about this drug if you have problems with steroids)
• Your doctor may have other medications to help you

If you feel side effects while receiving the drugs in the medical facility notify the staff.  Common discomforts are chills (which can be remedied by a warm blanket) and frequent urination which may be discolored (due to the adriamycin - a red drug).  Burning or red streaks at the IV site should be noted immediately..

Items to consider while on this regimen:

• Ask about drinking more fluids. Adriamycin and Vinblastine may cause kidney problems and liquids may help.  Also some regimen drugs may cause constipation which should be closely monitored.  Your doctor may prescribe a laxative to help.
• Ask your medical team about which pain relievers to take while on this regimen - some drugs thin the blood which is not recommended while on chemotherapy.

Side Effects:

• These drugs can cause nausea, vomiting, and loss of appetite. There are medications your doctor can prescribe such as Zofran or Kytril that may lessen chemotherapy induced nausea. 
• Fatigue is common during chemotherapy treatment.  Proper rest and pacing oneself may be helpful.
• Treatments can be delayed if the patient has a low white blood cell count (neutropenia). Blood counts can be raised by drugs such as Granulocyte Colony-Stimulating Factor (G-CSF, brand name Neupogen®) - a drug used to stimulate the production of granulocytes in the bone marrow.
• The drugs will make your hair tend to fall out (alopecia) - you might consider headcoverings.
• For support, see the Surviving Lymphoma section

Long Term:

• According to NCI (12/98), the risk of acute leukemia at 10 years following therapy with ABVD appears to be less than 1% (vs. 3% with MOPP at 5-9 years).
• NCI also says lung cancer is seen with increased frequency, and the risk of this cancer is increased with cigarette smoking. Therefore, patients who have been cured of Hodgkin's disease with radiation therapy or combined modality therapy (radiation + chemotherapy) should be strongly urged to stop smoking.
• Peripheral neuropathy (tingling in the hands and feet) may lessen over time.

Reference:

Hodgkin's Disease, Peter M. Mauch (Editor), James O. Armitage (Editor), Volker Diehl (Editor), June 1999.  Recent and complete with articles on all aspects of diagnosis, treatment, etc.  Written for medical professionals and expensive but worth it if you are an avid researcher of information on Hodgkin's.  

Studies: 

• A 2003 study confirms ABVD should be the standard treatment over MOPP/ABD in advanced Hodgkin's (article)
• Another 2003 study confirms the dacarbazine (D) in ABVD is definitely needed over using just the ABV in treating Hodgkin's

Resources for information on ABVD

• ABVD info from Cancerbackup (UK)
• Glen Martin's Remission.org has a good description of ABVD chemotherapy for Hodgkin's
• Tirgan Oncology page on ABVD
• Chemotherapy Regimens for Hodgkin's from Medicine On Line
• Information on peripheral neuropathy
• Books on Lymphoma Treatment including chemotherapy

Disclaimer: This information is general in nature. Please consult with a doctor or the literature provided with the drugs if you need specific information on a drug. The author is not responsible for missing or inaccurate information and the reader assumes full responsibility for their actions. As always, please consult with medical personnel before undertaking any medical treatment.

For more information on Adult Hodgkin's Disease, please see the following pages: :

• Hodgkin's Disease: Chemotherapy
• Hodgkin's Disease: Treatment
• Hodgkin's Disease: Resources
• Hodgkin's Disease: Diagnosis
• Hodgkin's Disease (Main Page)
• Bone Marrow / Peripheral Blood Stem Cell Transplants

• Childhood Hodgkin's Disease: Chemotherapy
• Childhood Hodgkin's Disease: Treatment
• Childhood Lymphoma: Resources
• Childhood Bone Marrow and Stem Cell Resource Page
• Childhood Hodgkin's Disease: Diagnosis
• Childhood Hodgkin's Disease: Introduction

The Main Page - gateway to support and more

• The Lymphoma Information Network

This page is a work in progress - if you have more complete information, references, or other information please contact the author. The author is not in the medical field and does not warrant the correctness of the material on this page or the sites linked - please take online information and consult with your own medical team to make informed decisions.

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Updated June 1, 2006