4 Down with Hyper/Cvad Course A

May 7, 2013 in Lymphoma by Jeffry Reed

4 Cytoxans down, 2 to go. This is a huge dose of Chemo…..it’s a huge bunch of cancer so it’s getting treated as such. Burkitt’s Lymphoma…..put down the hammer and get the sledge hammer.

I feel fine so far. The friggen steroids have me wanting to eat the plastic tubing, the chairs and the pillows….plus they keep me awake. I didn’t sleep last night. They gave me some anti anxiety meds this morning and I zonked out for a bit.

Lots of guests today….it sure is good to see familiar faces. I miss everybody at work. I wish I could see everyone but it’s not possible.

This is Course A….

I’ll be getting 2 more Cytoxans then the rest of the doses:

  • Cyclophosphamide (Cytoxan) is an alkylating agent given at 300mg/m2 by IV Q12hours over 3 hours (6 doses–2 to go) Days 1, 2, and 3
  • Vincristine (Oncovin) is a mitotic inhibitor, 2mg IV Days 4 and 11
  • Doxorubicin (Adriamycin or Rubex) is an antibiotic with anti-tumour effects, 50mg/m2 IV Day 4 (Red Devil)
  • Dexamethasone is an Immunosuppressant 40mg/day IV or PO Days 1 to 4 Days 11-14
  • Cytarabine or Ara-C (Cytosar) is an antimetabolite 70mg IT Day 7
  • Mesna (Uromitexan) is a compound used to reduce the incidence of haemorrhagic cystitis, a common side effect of the administration of cyclophosphamide. It is generally given via intravenous infusion or orally at the same time as cyclophosphamide.
  • Methotrexate, an antimetabolite, may be given via the intrathecal route when it is necessary to give chemotherapy which will pass through the blood–brain barrier. 12mg IT Day 2

So there it is……when I down this week’s course, I wait two weeks and then go back for a new dose of stuff…. Course B

Course B looks really different…

  • Methotrexate 1000mg/m2 IV over 24 hours Day 1
  • Leucovorin 25mg/ m2 IV 24 hours after starting methotrexate infusion Q6H X 6 doses. Leucovorin is used as a ‘rescue’ agent to prevent excessive cellular damage by methotrexate.
  • Sodium bicarbonate 600mg PO (starting day before methotrexate) TID X 4 Days. Sodium bicarbonate is used to produce a mild metabolic alkalosis, desirable when administering large quantities of methotrexate. Urine pH values will be checked to ensure alkalosis prior to the commencement of methotrexate.
  • Cytarabine3000mg/m2 IV over 2 hours Q12H X 4 doses Days 2 and 3

Typical Side effects….not going to list the atypical effects because…well. It’s not going to happen damnit. I’m young and strong and I’m sick of bad news and they can take the other side effects and shove em because they are not going to happen to me. I’m going to do this shit and be done with it and I’ll puke, lose weight, be hairless, and sleep, and that’s all that’s going to happen.

So typical side effects….

  • Temporary hair loss is a common side effect. Nausea and vomiting are commonly experienced both during and following administration. A variety of antiemetic drugs may be used, including granisetron, ondansetron, metoclopramide and cyclizine.
  • Fertility is often compromised following the administration of hyper-CVAD chemotherapy. Patients who wish may elect to store gametes as a contingency.
  • Peripheral neuropathy may be problematic following the administration of vincristine.

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