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Long term effects of ABVD-MOPP

JANNEY1998
Posts: 2
Joined: Apr 2017

Hi I have read these boards before a few years ago. Wasn't able to participate at the time. I am a HL survivor. I Was first diagnosed in 1995 (tumor in neck). Did rads then in 1997 itrecurred, did chemo (MOPP-ABVD) this time around. I finished my last chemo meds on 6/30/98 and haven't had any recurrence, but this Feb. 2017 I ended  up with cardiac tamponade. I am aware my lungs have scar tissue from the rads.  and have noticed how it affects me not being able to be as physical as I feel I should be able to. While going through the chemo I think it was the vincristine that I was told was so bad for the heart I had to have it in a pump over some days, anyone else have this?

I would like to know if anyone who has been through the mop abvd has had heart trouble from long term effects. I feel like some medical pros. don't agree with me that this is related. Or they don't want me to know. Just my feelings on the matter. Would appreciate if anyone has any info they could share about their experiences. I'm worried the cardiac tamponade could return and would like some feedback of people's experience that have had anything similar.

po18guy
Posts: 1099
Joined: Nov 2011

From MOPP, the Vincristine is known primarily for peripheral neuopathy. The Bleomycin in ABVD for lung toxicity and the Doxorubicin (Adriamycin) for cardiac toxicity - but cardiomyopathy rather than tamponade. The tamponade can be a result of the tumors impinging on the heart. If you can locate the consent to treatment forms you signed at the time, you will proably find reference to the toxic side effects of each drug. Truthfully, had you not consented to treatment you probalby would not be here.

Cancer can be a death sentence. Those of us who have survived are damaged goods. However, we must be alive to have complaints. I would suggest that you focus on maximizing what you have left and living as full a life as you can. 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3522
Joined: May 2012

Janney,

ABVD was developed in around the late 1970s (I dont recall the timeframe exactly) as a less toxic substitute for MOPP, the previous gold-standard against HL.  MOPP had (has) a higher proclivity to induce Leukemia than ABVD does.  MOPP is still of course in use, and is employed on patients who for whatever reason cannot tolerate ABVD.  As Po was noting, ABVD can have an assortment of horrible side-effects.  Bleomycin is the worst, and causes lung toxiticty (inflammation) in 10% of all users, and fibrosis (scarring of the lungs) in around 2% of all users.  Lung damage from Bleomycin is usually immediate in onset, not delayed years later. I myself have fibrosis, loss of about 25-30% of lung volumne. This is not repairable, but inhalers can help.  Bleomycin is continued in use because despite the risks, it is one of the most-effective killers of HL cancer cells.

Adrimycin (a drug in ABVD, CHOP, EPOCH, and many others) rarely (around 1-2% of all users) causes heart damage that mimics congestive heart failure: the heart wall muscles thicken, and become unable to flex-pump.  The onset of this can be delayed as long as 7 years or more.  I was tested for this about 3 years ago, thankfully negative. It is tested via ultrasound, and the tech calculates an "ejection output fraction", showing the efficiency of the heart.  If you get a heart ultrasound, know that a perfect score (maximum possible efficiency) is about 65 to 70%.   When the nurse said I had "about a 65" I thought I had a lot of imparement, but in fact had a nearly perfect score.

Po also mentioned Vinblastine-Vincristine, sister drugs, found in almost all Lymphoma combinations. These commonly cause neuropathy, but neuropathy is an inconvenience, not in any way life-threatening.

Combining any chemo with radiation slightly increases lifetime liklihood of a Leukemia years or decades later, but this is very slight.  You are much more likely to get struck by lightening, or eaten by an alligator.  Give thanks for each cancer-free day, and for years of wellness, is my view of all of this.

max

 

yesyes2
Posts: 592
Joined: Jul 2009

Hi Janney,

I am unfamiliar with the chemo you received as I had an entirely different trestment for blood cancer.  However I am aware of long term effects from both radiation and chemo on survivors of Hodgkins.  Have you checked finding a doctor who specializes in long term care for cancer survivors.  Most are found at major medical centers and specialize in children and Hodgkins lymphoma.  If you go back through old posts there was a women who used to post as she was being treated by a specialist for complications from treatment.  These posts are way back and her user name was something like Blue Rose, it was blue something.

Good luck in you search.

Leslie

JANNEY1998
Posts: 2
Joined: Apr 2017

Thank You for the responses. I have known that my lungs have had fibrosis (scarring), also was told I would never be able to have another child. I now have an almost 10 yr. old. I have been blessed with.  I had cardiac tamponade, they removed the blood off my heart, did a mri among other tests. On the report it says they diagnosed me with "Pericarditis". They have no findings of the usual things that cause it (cancer, infection, auto immune disease). I just want to know if statistics show this as being something caused from the treatment. And if it comes back or not. So thought I'd try and find some info. They had me scheduled to speak with an Oncologist about the long term effects of treatment. When the cancer tests showed negative the appointment was canceled. Thank You yesyes2 for the info I will see if I can find pld posts from  (Blue Rose).

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