Hodgkin's Lymphoma

I just got the word yesterday that my biopsy results showed I have hotchkins lymphoma. I am a little down about it, and curious on what the treatments are going to be like. I am keeping good spirits up by joking about it. My wife does not like me joking but....... Anyone else on here have hotchkins lymphoma?

 

Whatever decisions you make, I suggest going at them full force. Staying strong is the best thing to do when battling cancer.

 

My father-in-law had non-Hotchkins lymphoma. He had to take 6 rounds of Chemo which were spaced out every 3 weeks. Being he was 78 years old with prior heart trouble, his doctor suggested him not to do any radiation. After all the chemo he was cancer free. Good luck with your battle and always keep a positive attitude.

 

my wife had this about 5-6 yrs ago. she went for chemo once every other week for 6 months. she belongs to a forum that is set up just like this one and covers everything ya might need to know about lymphmo. i can send ya the link if ya want ,just lemme know

 

That would be helpful. Thanks

 

heres is that link dgr...goodluck to ya and if ya have any questions i could probaly ask the wife for you http://forums.lymphoma.com/

 

Thank you

 

I don't have any advice, but good luck and kick the shit out of it. I'm rooting for you, f**k cancer!

Never had HL in my family, but my dad had colon cancer and fought it off like a champ.

 

I do have to say that bone marrow biopsy sucks. Weirdest feeling ever, and the next day(today) I am super sore.

 

Hodgkin's lymphoma.

It'll probably help when you start googling to spell it right.

Good luck!

 

dgr... i wa sin the room and watched it get done on my wife... she of cours edidnt know what was goin on except what the dr was tellin her so after it was done i said man you shoulda seen the size of that thing i thought it was gonna poke out your stomach and hit the floor.......at least it made her laugh. let me know what stage you are when ya find out. im pullin for ya dude

 

Best of luck man. I have a friend that is going through a bunch of tests to find out if he has cancer or not. It is not easy. Keep your head and spirits up and beat the hell out of this cancer.

 

I just had my final exam in pharmacy school for oncology today - seriously how crazy is that.

Therapy you may see:

ABVD,
BEACOPP
Stanford V
ICE (ifosfamide+carboplatin
+etoposide)
DHAP (dexamethasone+cisplatin
+high-dose cytarabine)
ESHAP (etoposide+methylprednisolone
+high dose cytarabine
+cisplatin)


Treatment
· Typically curable even in the advanced stages
· 20-year-disease-free survival rate is >60%
· Chemotherapy-sensitive disease and administration of full doses is critical.
· The risk of TLS is low with the treatment of Hodgkin’s lymphoma. (Management usually includes drinking water in outpatient setting & self monitor for urination)
1. Local Disease
A. Stage IA-radiation
B. Stage IB, IIA, IIB-radiation ±chemotherapy
2. Advanced disease
A. Combination therapy

ABVD
Stanford V
BEACOPP
Doxorubicin
(Adriamycin)
Doxorubicin
Bleomycin
Bleomycin
Vinblastine
Etoposide
Vinblastine
Mechlorethamine
Doxorubicin (Adriamycin)
Dacarbazine
Etoposide
Cyclophosphamide
Vincristine
Vincristine (Oncovin)
Bleomycin
Procarbazine
Prednisone
Prednisone


3. Relapsed disease (after ABVD)
A. Combination therapy
a. There are multiple regimens
i. Refer to the guideline and website
B. High-dose chemotherapy with stem cell support

I. Agents
1. Mechlorethamine – Mustargen
· MOA
o Nitrogen mustard, alkylating agent
· PK
o In water or body fluids, mechlorethamine undergoes rapid chemical transformation and combines with water or reactive compounds so the active drug is no longer present within a few minutes. (T1/2<1min)
o ADRs
o BMS (Neutropenia, thrombocytopenia)
o N/V (Level 5)
o Vesicant (antidote: Sod. thiosulfate)
o corrosivity, carcinogenicity, mutagenicity, teratogenicity
o Alopecia
o Atopic dermatitis (topical use)

· Other
o Must be used within 1 hour post-reconstitution (15-60 minute stability)
o Major stability issues, incompatible



2. Procarbazine – Matulane
· MOA
o “pseudo-alkylating agent”
o methylhydrazine derivatives
o It inhibits transmethylation of methyl groups of methionine into t-RNA.
o its metabolites exhibit effects similar to the alkylating antineoplastics but lack the cross resistance with classical alkylators
o it is unrelated to other antineoplastics and may be effective when others have become ineffective
· PK
o PO route (Rapid and almost complete absorption)
o Half-life of 10 minutes
o Metabolized by CYP and MAO
o Weak MAO inhibitor
o Given as one or split dose based on N/V
· ADR’s
o BMS (Neutropenia, thrombocytopenia)
o N/V (level 4)
o CNS toxicity (paresthesias, neuropathies, ataxia, lethargy, HA, confusion, seizures)
o Dermatologic toxicity (pruritus, urticaria, flushing, maculopapular skin rash)
o Secondary maliganacy
o Disulfiram-like reaction
o alopecia
o Flu-like syndrome is common
o stomatitis or diarrhea with frequent bowel movements
o Reproductive failure

· Drug Interactions
o ETOH
o MAO interaction
o Tyramine rich foods (Beer, cheese, wine)
o Sympathomimetics
o TCA’s, Fluoxetine
o linezolid



3. Dacarbazine – DTIC-Dome
· MOA
o alkylating agent (triazenes)
§ Action as an alkylating agent.
§ Inhibition of DNA synthesis by acting as a purine analog.
§ Interaction with sulfhydryl (SH) groups.
· PK
o localization in some body tissue, probably the liver
o Protect from light
o Use within 8 hours of reconstitution

· ADR’s
o BMS (leukopenia= thrombocytopenia)
o N/V (level 5)
o Injection site reaction (irritant)
o Alopecia
o CNS toxicity (seizures)
o Flu-like syndrome
o Hepatotoxicity (Hepatic toxicity accompanied by hepatic vein thrombosis and hepatocellular necrosis resulting in death)



4. Bleomycin – Bleoxane
· MOA
o An anti-tumor antibiotic
o Intercalates DNA producing strand breaks and helix unwinding
o Complexes with iron, oxygen and DNA generating DNA damaging free radicals
· PK
o 60-70% eliminated unchanged by the kidney
o dose adjustment required in PTs with renal dysfunction
· ADR’s
o Pulmonary (fibrosis, pneumonitis)
§ Incidence is higher in elderly patients and in those receiving greater than 400 U total dose
§ Judicious use of supplemental oxygen
o Skin reactions (pruritus, hyperpigmentation)
o Idiosyncratic reactions (similar to anaphylaxis)
§ hypotension, mental confusion, fever, chills, and wheezing
§ PremedicationL Tylenol 650mg PO + Benadryl 25 mg PO.
§ treatment: antihistamines, corticosteroids, pressor agents, and volume expansion
§ give 1-2 unit test dose IV and wait 1-2 hours
· Other
o Chest radiation (with or prior to bleomycin) increases pulmonary toxicity risk

 

If u have any questions, be sure to ask. I can email u the NCCN guidelines too. One good thing about Hodgkins lymphoma is that it is more cureable than non-hodgkins lymphoma

 

Well I am one infusion in and eleven to go, but the nausea for the first 2 days sucked. They gave me Zofran for that, but I am also experiencing painful tingling on the side of my tongue. Other than that just minor fatigue.

 

hang in there

 

Stay positive, humour is one of the best medicines

 

I had a friend that went through that when he was your age. They treated him with full body radiation, which was apparently not the right thing to do, but that's what they were doing at the time. He had numerous complications from the radiation, mostly scar tissue in his heart. Even with that, he lived another 30 years, had three kids and a successful career as a structural engineer.

I'm sorry I can't offer you any idea of what you're going to go through, but just wanted to post and try to offer some encouragement. A positive attitude goes a long way. My friend Jim always was the most positive person in the room and he kicked that cancer's ass and had another 30 years with us! There's been 30 years of medical science since he got sick. No reason why you can't get through this and live a full life!

 

You're still young dude, you'll kick the crap outta this and go on to do bigger better and stupider things!

 

That is for sure. I was suppose to do another infusion this past monday, but my white blood cells were extremely low so I have to wait another week