Care During Chemotherapy and Beyond
Generic Name: Bendamustine Hydrochloride
Trade Name(s): Treanda®
Bendamustine is the generic name for the chemotherapy drug
Treanda ®. In some cases, health care professionals may use the trade
name Treanda ® when referring to
the generic drug name Bendamustine.
Bendamustine is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Bendamustine
is classified as an "alkylating agent". For more detail, see How
Bendamustine Works below.
Is Used For:
- Bendamustine is used for treatment of chronic lymphocytic leukemia (CLL).
- Bendamustine is used for the treatment of patients with indolent B-cell non-Hodgkin's
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 Bendamustine Is Given:
As an injection into the vein (intravenous,
There is no
pill form of Bendamustine.
The amount of Bendamustine 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 being
treated. Your doctor will determine your dose and schedule.
Bendamustine Side Effects:
Important things to remember about the side effects of Bendamustine:
Most people will not experience all of the Bendamustine side
Bendamustine side effects are often predictable in terms of their onset, duration,
Bendamustine side effects are almost always reversible and will go away after therapy
Bendamustine side effects may be quite manageable. There are many options to minimize
or prevent the side effects of Bendamustine .
The following Bendamustine side effects are common (occurring
in greater than 30%) for patients taking Bendamustine:
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 bleeding.
Nadir Meaning low
point, nadir is the point in time between chemotherapy cycles in which you experience
lowest blood counts.
Nadir: 14 to 21 days
Recovery: 28 days
Increase in bilirubin
These are less common side effects (occurring in about 10-29%)
for patients receiving Bendamustine:
Infusion reaction (chills,
fever, itching, rash) may require pre-medications,
Rare but serious complications of Bendamustine therapy.
Tumor lysis syndrome may occur as a result of leukemia
treatment including treatment with Bendamustine. Tumor lysis
syndrome occurs when large amounts of cancerous cells are rapidly killed by the
therapy. These cells release uric acid, potassium and phosphorus into the blood
stream. Tumor lysis syndrome can lead to kidney failure. Tumor lysis syndrome usually
occurs within 24 – 48 hours of therapy. Care must be taken to prevent the development
of tumor lysis syndrome. Your health care provider will prescribe plenty of fluids
to keep you hydrated. You may be given a drug called allopurinol that blocks uric
acid production. In some cases, your health care provider may prescribe other measures
to lower your white blood count before therapy. Let your health care provider know
immediately if you are unable to urinate. Your health care provider will monitor
your progress carefully during therapy.
Infertility (loss of fertility). Meaning, your ability
to conceive or father a child may be affected by Bendamustine.
Discuss this issue with your health care provider.
This list includes common and less common side effects for those taking
Bendamustine. Bendamustine side effects that are very rare -- occurring
in less than about 10 percent of patients -- are not all listed here. Always inform
your health care provider if you experience any unusual symptoms.
When To Contact Your Doctor
or Health Care Provider:
Contact your doctor or health care provider immediately, day or night, if you should
experience any of the following symptoms:
Fever of 100.5° F (38° C) or higher, chills (possible
signs of infection)
The following symptoms require medical attention, but are not an emergency. Contact
your doctor or health care provider within 24 hours of noticing any of the following:
Nausea (interferes with ability to eat and unrelieved with prescribed
Vomiting (vomiting more than 4-5 times in a 24 hour period)
Diarrhea (4-6 episodes in a 24-hour period)
Black or tarry stools or blood in your stools
Blood in your urine
Pain or burning with urination
Extreme fatigue (unable to carry on self-care activities)
Severe or worsening Rash
Yellowing of the skin or eyes.
Unable to eat or drink
for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and
decrease amount of urine, or dizziness.
Always inform your doctor or health care provider if you experience any unusual
Before starting Bendamustine treatment, make sure you
tell your doctor about any other medications you are taking (including prescription,
over-the-counter, vitamins, herbal remedies, etc.).
While taking Bendamustine do not take aspirin or products
containing aspirin unless your doctor specifically permits this.
While taking Bendamustine , do not receive any kind of immunization
or vaccination without your doctor’s approval.
Inform your health care professional if you are pregnant or may be pregnant prior
to starting Bendamustine. Pregnancy category D (Bendamustine
may be hazardous to the fetus. Women who are pregnant or become pregnant
must be advised of the potential hazard to the fetus).
For both men and women: Use contraceptives and do not conceive a child (get pregnant)
while taking Bendamustine. Barrier methods of contraception
such as condoms are recommended.
Do not breast feed while taking Bendamustine.
Self-Care Tips While Taking Bendamustine:
taking Bendamustine, try to drink at least two to three quarts of fluid every 24
hours, (particularly the 24 hours before and 48 hours following the infusion) unless
you are instructed otherwise.
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.
your hands often.
Use an electric razor and a soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
help treat/prevent mouth sores while taking Bendamustine, use a soft toothbrush,
and rinse three times a day with 1 teaspoon of baking soda mixed with 8 ounces of
reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat
small, frequent meals while taking Bendamustine.
sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
You may experience drowsiness or dizziness; avoid driving
or engaging in tasks that require alertness until your response to the drug is known.
general, drinking alcoholic beverages should be kept to a minimum or avoided completely
while you are taking Bendamustine. You should discuss this with your doctor.
plenty of rest.
good nutrition while being treated with Bendamustine.
you experience symptoms or side effects while being treated with Bendamustine, 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
While Taking Bendamustine:
You will be checked regularly by your doctor while you are taking Bendamustine
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).
How Bendamustine 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 or apoptosis).
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.
Bendamustine is classified as an alkylating agent. Alkylating agents
are most active in the resting phase of the cell-cycle. There are several
types of alkylating agents. Bendamustine is a nitrogen mustard derivative and is
active against resting as well as dividing cells.
Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this web site is meant to be helpful and educational, but is not a substitute
for medical advice.
Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org