Numb fingers with ABVD

[lymphpre]

Hello folks,
My name is Simon, and I am having a second relapse of lymphocyte predominant hodgkins lymphoma. I was previously treated 11 years ago with ClVPP, and 15 years ago with radiation therapy. I've just started 3rd cycle of R-ABVD. Yesterday, I noticed a loss of sensation in the fingertips of my left hand. I assume this is the vinblastine. Has anyone else experienced this side effect? Am I going to have number fingers from now until after the treatment finishes, or is this something that will come and go between cycles? Is it something I should contact my Dr about before the next dose of chemo?

Any thoughts or advice much appreciated.
Simon

[pinkmada]

hey Simon,
sorry to hear you are having another relapse. yeah the numbness and tingling is caused by the vinblastine. you really have to call the doctor or the nurse asap and let them know. did they give you allopurinal? they gave me that for my first 3 cycles to prevent that happening but i remember my onc telling me that i was to call if i was experiencing any tingling/numbness.
good luck
x

[lymphpre]

Thanks for the reply. Interesting that you mention allopurinol, as they gave me that for the first two cycles only, and this has happened on the first cycle without it. However the doc said it was to stop gout from the tumours releasing uric acid, not to prevent the peripheral neuropathy. My consultant did warn me there was a higher risk of getting this side effect, as my previous chemo had also featured vinblastine.

Just phoned the doc now, who confirmed that it would be due to the vinblastine. He said they will probably drop it from my next treatment.

Thanks
Simon

[pinkmada]

hey,
I 'think' that the tingling can be a first symptom of gout. I think someone may have told me last year. i just remember being told to take the allopurinal for the first 6 weeks as it reduces the chance of tingling for the rest of the treatment. and i think tingling can be caused by the release of uric acid, or mabye lactic acid?
Can i ask, when you are in recieving treatment does one of the drugs (i cant remember which one it was always the third one i got, in the dark bag.) really really hurt your arm when its going in? i remember they told me that it can feel 'strange' and gave me a heat pad but that made it sooo much worse and i ended up laying an icelolly on my arm while getting the drug and the nurses thought it was strange i felt like it was burning.

i had the bleomycin dropped near the end because i started feeling really short of breath.

xxx

[lymphpre]

Hi Amanda,
This is all very interesting. I was told that although they were giving me allopurinol for two cycles, I probably only needed it for one, as I do not have a particularly large tumour mass. The Dr said that it is really only necessary when there is a large tumour mass to break down, because that is when you get lots of uric acid by-product.

Yes, the dacarbazine does hurt my arm. Unfortunately, they seem to have trouble getting a cannula in, so the same vein has been used each time. It has now gone hard, and is permanently sore. I think this will cause problems as they obviously cannot carry on using it, and do not seem able to get access any of the others. I have tried the heat pad once, and it did not make a difference. They might be able to slow the infusion down, but if I'm having rituximab as well, it takes over 6 hours anyway. I really do not fancy having a line put it, as I've read about all the possible complications that can come from that.

The Bleomycin does worry me, as I have read a lot about the pulmonary damage it can cause, and also that dropping it from the protocol does not seem to make a difference. I definately get out of breath more easily since starting the treatment, although less so in the second week. If it continues to get worse, I think I will ask for a test of pulmonary function.

Best wishes
Simon