Care During Chemotherapy and Beyond
Trade names: Nipent®
Nipent is the trade name for pentostatin. In some cases, health care professionals
may use the trade name Nipent when referring to the generic drug name pentostatin.
Drug type: Pentostatin is an anti-cancer (“antineoplastic” or “cytotoxic”)
chemotherapy drug. This medication is classified as an “antimetabolite”.
(For more detail, see “How this drug works” section below.)
What Pentostatin Is Used For:
- This medication is used in the treatment of hairy cell leukemia. It may also
be used in certain non-hodgkin lymphomas, including cutaneous t-cell lymphoma.
Note: If a drug has been approved for one use, physicians may elect to use
this same drug for other problems if they believe it may be helpful.
How Pentostatin Is Given:
- This medication is given by infusion through a vein (intravenously, by IV).
- There is no pill form of this medication.
- The amount of pentostatin that you will receive depends on many factors, including
your height and weight, your general health or other health problems, and the type
of cancer or condition you have. Your doctor will determine your exact dosage
Important things to remember about the side effects of pentostatin:
- You will not get all of the side effects mentioned below.
- Side effects are often predictable in terms of their onset, duration, and severity.
- Side effects are almost always reversible and will go away after therapy is complete.
- Side effects are quite manageable. There are many options to minimize or prevent
The following side effects are common (occurring in greater than 30%)
for patients taking pentostatin:
- Nausea and vomiting
- Low blood counts. Your white and red blood cells and platelets may temporarily
decrease. This can put you at increased risk for infection, anemia and/or
Nadir: Meaning low point, nadir is the point in time between chemotherapy
cycles in which you experience low blood counts.
Nadir: 7 days
Recovery: 10-14 days
The following side effects are less common (occurring in 10-29%) for patients
- Muscle aches
- Abdominal pain
- Upper respiratory infection
- Mouth sores
- Shortness of breath
This list includes common and less common side effects for those taking pentostatin.
Side effects that are very rare -- occurring in less than about 10 percent of patients
-- are not listed here. But you should always inform your health care provider
if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you should
experience any of the following symptoms:
- Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
- Shortness of breath, difficulty breathing
The following symptoms require medical attention, but are not an emergency.
Contact your health care provider within 24 hours of noticing any of the
- Nausea (interferes with ability to eat and unrelieved with prescribed medication).
- Vomiting (vomiting more than 4-5 times in a 24 hour period).
- Diarrhea (4-6 episodes in a 24-hour period).
- Unusual bleeding or bruising
- Black or tarry stools, or blood in your stools.
- Blood in the urine.
- Pain or burning with urination.
- Extreme fatigue (unable to carry on self-care activities).
- Mouth sores (painful redness, swelling or ulcers).
Always inform your health care provider if you experience any unusual symptoms.
- Before starting pentostatin treatment, make sure you tell your doctor about any
other medications you are taking (including prescription, over-the-counter, vitamins,
herbal remedies, etc.). Do not take aspirin or products containing aspirin
unless your doctor specifically permits this.
- Do not receive any kind of immunization or vaccination without your doctor’s approval
while taking pentostatin.
- For both men and women: Use contraceptives, and do not conceive a child (get pregnant)
while taking pentostatin. Barrier methods of contraception, such as condoms, are
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category D (Pentostatin may be hazardous
to the fetus. Women who are pregnant or become pregnant must be advised of
the potential hazard to the fetus). Do not breast feed while taking this medication.
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed
- You may be at risk of infection so try to avoid crowds or people with colds, and
report fever or any other signs of infection immediately to your health care provider.
- Wash your hands often.
- To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times
a day with 1 teaspoon of baking soda mixed with 8 ounces of water.
- Use an electric razor and a soft toothbrush to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, and
eat small, frequent meals.
- Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided
completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that
are effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your doctor while you are taking pentostatin, to
monitor side effects and check your response to therapy. Periodic blood work
will be obtained to monitor your complete blood count (CBC) as well as the function
of other organs (such as your kidneys and liver) will also be ordered by your doctor.
How Pentostatin Works:
Cancerous tumors are characterized by cell division, which is no longer
controlled as it is in normal tissue. "Normal" cells stop dividing when they come
into contact with like cells, a mechanism known as contact inhibition. Cancerous
cells lose this ability. Cancer cells no longer have the normal checks and balances
in place that control and limit cell division. The process of cell division, whether
normal or cancerous cells, is through the cell cycle. The cell cycle goes from the
resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt
cell division. Usually, the drugs work by damaging the RNA or DNA that tells the
cell how to copy itself in division. If the cells are unable to divide, they die.
The faster the cells are dividing, the more likely it is that chemotherapy will
kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle
specific. Chemotherapy drugs that affect cells when they are at rest are called
cell-cycle non-specific. The scheduling of chemotherapy is set based on the type
of cells, rate at which they divide, and the time at which a given drug is likely
to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately,
chemotherapy does not know the difference between the cancerous cells and the normal
cells. The "normal" cells will grow back and be healthy but in the meantime, side
effects occur. The "normal" cells most commonly affected by chemotherapy are the
blood cells, the cells in the mouth, stomach and bowel, and the hair follicles;
resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss.
Different drugs may affect different parts of the body.
Pentostatin belongs to the class of chemotherapy drugs called antimetabolites.
Antimetabolites are very similar to normal substances within the cell. When the
cells incorporate these substances into the cellular metabolism, they are unable
to divide. Antimetabolites are cell-cycle specific. They attack cells at very specific
phases in the cycle. Antimetabolites are classified according to the substances
with which they interfere. Pentostatin is classified as an adenosine deaminase inhibitor.
Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
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