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DHAP

Find out what DHAP is, how you have it and other important information about having DHAP.

DHAP is the name of a cancer drug combination. It includes the drugs:

  • D – dexamethasone, which is a steroid
  • HA – high dose Ara C, also known as cytarabine
  • P – cisplatin

It is a treatment for:

  • high grade non Hodgkin lymphoma that has come back
  • Hodgkin lymphoma that has come back

How DHAP works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells. Dexamethasone is a steroid and can help the chemotherapy to work better.

How you have it

Ara C and cisplatin are clear fluids and you have them into your bloodstream (intravenously).

You usually have the steroid (dexamethasone) as daily tablets (orally) but you may have it into a vein (intravenously) instead. 

Into your bloodstream

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Taking your tablets or capsules

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

When you have it

You usually have DHAP chemotherapy as cycles of treatment. You may have between 2 and 6 cycles and each cycle lasts 3 weeks.

You have the treatment in the following way.

Day 1
  • You have cisplatin as a drip which lasts for 24 hours. You also start taking the dexamethasone tablets for 4 days or else have dexamethasone into your drip.
Day 2
  • You have cytarabine (Ara C) as a drip twice. Each drip lasts for 3 hours and you have them 12 hours apart.
If you have the dexamethasone as tablets you will be able to go home and carry on taking the tablets for 2 more days. If you have the dexamethasone into your drip you will need to go back into the hospital each day for 2 more days.

You also have fluids (hydration) into your drip or central line during your first two days of treatment. This is because DHAP can cause kidney damage and the extra fluids help to keep your kidneys working properly.

Your doctor will give you steroid eye drops to take for 5 to 7 days. The drops help to stop your eyes getting sore.

When you stop taking the dexamethasone tablets you have no treatment for just over 2 weeks. You then start the next cycle.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Fertility

You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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