Chemotherapy Combination ABVD

An abbreviation for a chemotherapy combination used to treat Hodgkin lymphoma. It includes the drugs doxorubicin hydrochloride (Adriamycin), bleomycin sulfate, vinblastine sulfate, and dacarbazine. Also called ABVD

This chemotherapy combination contains the drugs doxorubicin hydrochloride (Adriamycin), bleomycin, vinblastine sulfate, and dacarbazine. Combinations usually work better than single drugs because different drugs kill cancer cells in different ways.

ABVD is the name of a chemotherapy combination that includes:

A – doxorubicin (Adriamycin)
B – bleomycin
V – vinblastine
D – dacarbazine (DTIC)
It is a treatment for Hodgkin lymphoma.

Medical uses
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 intravenously. ABVD chemotherapy is usually given in the outpatient setting — that is, it does not require hospitalization.[citation needed]

Typical dosages for one 28-day cycle of ABVD are:

Drug    Dose    Mode    Days
Adriamycin    25 mg/m2    IV bolus    Days 1 and 15
Bleomycin    10 IU/m2    IV bolus    Days 1 and 15
Vinblastine    6 mg/m2    IV bolus    Days 1 and 15
Dacarbazine    375 mg/m2    IV infusion    Days 1 and 15
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 FDG PET scan is commonly advised following the completion of ABVD to assess response to the therapy. Interim PET (following 2 cycles) may be useful in aiding prognostication, but does not yet guide changes in therapy except within clinical trial protocols.[2]

Side effects
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 myelosuppression, occur about 50% of the time with ABVD. Blood cell 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 sperm counts in men decrease during chemotherapy, they return to normal after completion of ABVD.[4][5][6] In women, follicle-stimulating hormone levels remained normal while receiving ABVD, suggesting preserved ovarian function. Regardless of these data, fertility options (e.g. semen cryopreservation, oocyte cryopreservation, embryo cryopreservation) should be discussed with an oncologist before beginning ABVD therapy.
Pulmonary toxicity, or lung damage, can occur with the use of bleomycin in ABVD, especially when radiation therapy to the chest is also given as part of the treatment for Hodgkin lymphoma. This toxicity develops months to years after completing chemotherapy, and usually manifests as cough and shortness of breath. High concentrations of oxygen, such as those often used in surgery, can trigger lung damage in patients who have received bleomycin, even years later. 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.Retrospective analyses have questioned whether bleomycin is necessary at all; however, at this point it remains a standard part of ABVD.
Cardiac toxicity, or cardiomyopathy, can be a late side effect of 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

Important: The drug information on this page is meant to be educational. It is not a substitute for medical advice. The information may not cover all possible uses, actions, interactions, or side effects of this drug, or precautions to be taken while using it. Please see your health care professional for more information about your specific medical condition and the use of this drug.