ABVD is a combination chemotherapy regimen that was developed in the early 1970's as an alternative to MOPP which was highly myelosuppressive. ABVD is now one of the most common chemotherapy regimens for treating Hodgkin's Disease.
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. Go here for more information on quit smoking help.
• Peripheral neuropathy (tingling in the hands and feet) may lessen over time.
Resources
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
Related Articles
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
For more information on Childhood Hodgkin's Disease, please see the following pages:
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
Books
Books on Lymphoma Treatment including chemotherapy
