Do Retuxin + Bendamustine side effects intensify with treatments?

Beach Bum,

I grew up near the beaches of Charleston, SC -- especially Folly, which is the most "Bohemian" beach in the state: sawdust-floored oyster bars, etc.

I did not use your exact meds, having used R-ABVD for six months instead, but R-ABVD does share the Rituxan with your B & R.   And because Bendamustine is a "conventional" chemo, meaning that it is a cytotoxic alkalyning agent, and works like many other cytotoxic (tumor-killing) drugs, I can speak in generalizations.

Yes, the more chemo a person gets, usually, the worse the side-effects. Most people indeed note that side-effects worsenen with more dosage.  This is more true in people who get a LOT of drugs over longer time frames; people who do a little chemo for a short period, less so.

The worsening will come much more from the Bendamustine than the Rituxan.  If you go on maintenance Rituxan for a long period after Bendamustine ends (a very common thing), the effects will be less.  Rituxan is not a "conventional" chemo, but rather what is called a "monoclonal antibody."  It is also used against inflammatory arthritis on patients with no cancer.  

Rituxan can cause joint and musclle pain, and symptoms that feel like a cold for some people, but these are usually not too dibilitating.

So a best-guess is that yes, you will feel weaker through the remaining B & R, but thereafter, things should mitigate.  If you do NOT take Rituxan for maintenance, you will begin to regain strength after a month or two.

Let me stress: These are generalities; what most people report. Specific cases often differ a lot from what I have described here.

I hope you feel better soon,

max

http://chemocare.com/chemotherapy/drug-info/bendamustine.aspx

Be aware that Rituxan goes by three or four different names in the medical community:

RITUXAN:  http://chemocare.com/chemotherapy/drug-info/Rituxan.aspx

.

I agree with everything Max said. A co-worker who is a breast cancer survivor warned me that the effects of the drugs would get stronger with each treatment cycle.  It is not just chemo drugs that does that. I am on blood pressure & thyroid meds. When started or the dosage is changed the effect is not immediate. It can take a week or more for the new dosage level to kick in. The only difference is the chemo is killing part of our system with the goal of fighting the cancer. 

I am now on Rituxan maintenance and keep a bottle of Tylenol handy for the first few days after a treatment. Best I can recommend is keep notes on what happens during the treatment cycle. Then use that first list to create a schedule allowing for the expected good days and bad days. That helped me get through it all. 

Good luck Beach Bum.

I was diagnosed with marginal zone lymphoma as well like you not splenic but my tumor was on the pelvic area. I got to have 5 rounds of R-CHOP which is a stronger chemo than yours every 21 days. You have only one chemo drug Bendamustine since Rituxan is not a chemo drug but indeed once you get to the 5 or 6 infusions there are cumulative effects of the drugs. The first week after infusion was always the worst for me specially after I finished taking Prednisone that comes with R-CHOP. Week 2 and 3 were a lot better with more energy. There is also the mental componenet once you know that you are almost done towards the end of the rounds you feel like it never finishes. Now I am waiting for the hair to grow. I think with your treatment you do not lose your hair correct?

Hope you go over it with as little side effects as possible.

Good luck!

Dana

BeachBum23 said:

Hi Dana,

Hi Dana,

You are correct, I won't lose my hair. I have had significant shedding, which I am very aware of, but others can't tell. Thanks for the response! I don't know anyone else who has been through this, so it's really helpful to hear from others who have had similar experiences. Glad you made it through all your rounds and hope your hair is coming back.

BB

My hair started coming out just before my second round of R-Chop. Within a few days it was pretty much gone.  For as fast as it went it is taking forever to grow back. Best wishes to you. 

Fear the cancer more than the chemo! The chemo can be dose-adjusted, stopped and re-started if necessary - even changed out for another regimen. Cancer has no such limitation. There are often infusion reactions to Rituxan - like an allegic reaction. Benadryl is ued to control it. It can subside with time. Bendamustine is a standard chemotherapy drug and its effects will be cumulative. It is impossible to say precisely how your body will respond to it. Doctor or nurse should have advised you of the common side effects, or you can just check Wiki. However, there are far worse regimens out there, many of us have received them, and we have all survived.

I can only comment on the R part. My initial therapy for stage IV FNHL was a high dose of Rituxan once per week for 8 weeks followed by one dose every 8 weeks for 2 1/2 years. It seemed to work wonderfully. I went to MD Anderson for follow up second opinion and had NED. Wonderful but ...... my case was unusual. I had tumors around my aorta which were surgically treated - worst part of the whole experience. There were medical mistakes - "nicking" of my aorta and liver Resulting in liver damage and severe bleeding. Scary. Medical mistakes are the third leading cause of death. But hey - these things happen and I had a great surgeon.

1st dose was memorable. About 2 hours in everything started getting blurry. At first I thought it was the percocet and Benadryl. Then I blacked out and was resuscitated by a rescue team from the adjoining hospital. The Rituxan was started again at a lower dose. That first infusion took 10 hours. Good news - after that my next 25 infusions were uneventful, even boring. It seems that my allergic reaction on the first dose was unusual in its severity but many people have a reaction on first dose. Mine was perhaps severe because I was recovering from surgery I had 2 months early.

i suffered knee and leg pains which went away after the treatments ended. My fingernails also went weird and I developed severe ctaracts but those two things are probably not related to rituxan.  Rituxan is truly a miracle to which I owe my life. I have new symptoms and other cancer issues but they probably are unrelated to Rituxan.

good luck!