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Care During Chemotherapy and Beyond

Vincristine Liposomal

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Trade Name: Marqibo

Vincristine liposomal is the generic name for the trade name drug Marqibo®. In some cases, health care professionals may use the trade name Marqibo® when referring to the generic drug name vincristine liposomal.

Drug Type:

Vincristine liposomal is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Vincristine is classified as a plant alkaloid. For more detail, see "How Vincristine Liposomal Works" section below.

What Vincristine Liposomal Is Used For:

  • Vincristine liposomal is used to treat Acute Lymphoblastic Leukemia (ALL: Philadelphia chromosome-negative), relapsed.
  • Vincristine liposomal and conventional vincristine are NOT interchangeable.

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 Vincristine Liposomal Is Given:

  • Vincristine liposomal is given as an infusion into the vein (intravenous, IV) over 1 hour.
  • Vincristine liposomal is NOT intended for intrathecal (spinal cord/brain) use.
  • The amount of vinvristine liposomal 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 and schedule.
  • Vincristine liposomal is a vesicant. A vesicant is a chemical that causes extensive tissue damage and blistering if it escapes from the vein. If you notice pain, redness or swelling at the IV site while you are receiving vincristine liposomal, alert your health care professional immediately.

Side Effects:

Important things to remember about the side effects of vincristine liposomal:

  • Most people do not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset and duration.
  • Side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of vincristine liposomal.

The following side effects are common (occurring in greater than 30%) for patients taking vincristine liposomal:

These side effects are less common side effects (occurring in about 10-29%) of patients receiving vincristine liposomal:

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, 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 100.4º F (38º C), chills (possible signs of infection)
  • Go directly to the Emergency Room (ER) if you have signs of a very bad reaction to the drug. These include wheezing; chest tightness; fever; itching; bad cough; blue or grey skin color; seizures; or swelling of face, lips, tongue or throat.

Always inform your health care provider if you experience any unusual symptoms.

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Diarrhea (4-6 episodes in a 24-hour period).
  • Nausea (interferes with ability to eat and unrelieved with prescribed medication).
  • Vomiting (vomiting more than 4-5 times in a 24 hour period).
  • 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.
  • Shortness of breath, accompanied by cough and/or fever.
  • Skin or the whites of your eyes turn yellow
  • Urine turns dark or brown (tea color)
  • Decreased appetite
  • Pain on the right side of your stomach
  • Bleed or bruise more easily than normal
  • Itching or rash
  • Changes in thinking clearly with logic
  • Numbness or tingling in your hands or feet
  • Signs of infection. These include: very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, wound that will not heal or anal itching or pain.
  • Big change in balance
  • A big weight gain
  • 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)
  • Very bad swelling

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

  • Before starting vincristine liposomal 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 receive any kind of immunization or vaccination without your doctor's approval while taking vincristine liposomal.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (vincristine liposomal 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: Do not conceive a child (get pregnant) while taking vincristine liposomal. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking this medication.

Self-Care Tips:

  • Drink 2 to 3 quarts of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. This will decrease your chances of being constipated, and prevent dehydration.
  • 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 healthcare provider.
  • Wash your hands often.
  • When working in your yard, wear protective clothing including long pants and gloves.
  • Do not handle pet waste.
  • Keep all cuts or scratches clean.
  • Shower or bath daily and perform frequent mouth care.
  • Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
  • Ask your doctor or nurse before scheduling dental appointments or procedures.
  • Ask your doctor or nurse before you, or someone you live with, has any vaccinations.
  • 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. Good mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help.
  • For constipation, drinking more liquids, working out, or adding fiber to your diet may help. Talk with your doctor about a stool softener or laxative.
  • 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.
  • For flu-like symptoms, keep warm with blankets and drink plenty of liquids. There are medications that can help reduce the discomfort caused by chills.
  • Acetaminophen or ibuprophen may help relieve discomfort from fever, headache and/or generalized aches and pains. However, be sure to talk with your doctor before taking it.
  • Keep your mouth clean with baking soda and salt rinses. You can mix 1/2 to 1 tsp. of baking soda and/or 1/2 to 1 tsp. salt in 8 ounces of water, and use as a mouthwash, to avoid or decrease the severity of mouth sores.
  • 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.

How Vincristine Liposomal 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.

Vincristine liposomal belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. The vinca alkaloids are made from the periwinkle plant (catharanthus rosea). The taxanes are made from the bark of the Pacific Yew tree (taxus). The vinca alkaloids and taxanes are also known as antimicrotubule agents. The podophyllotoxins are derived from the May Apple plant. Camptothecan analogs are derived from the Asian "Happy Tree" (Camptotheca acuminata). Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors. The plant alkaloids are cell-cycle specific. This means they attack the cells during various phases of division.

Vinca alkaloids: Vincristine Liposomal, Marqibo®, Vincristine, Vinblastine and Vinorelbine

Taxanes: Paclitaxel and Docetaxel

Podophyllotoxins: Etoposide and Tenisopide

Camptothecan analogs: Irinotecan and Topotecan

Antimicrotubule agents (such as vincristine liposomal), inhibit the microtubule structures within the cell. Microtubules are part of the cell's apparatus for dividing and replicating itself. Inhibition of these structures ultimately results in cell death.

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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