This page tells you about the chemotherapy drug combination Stanford V and its possible side effects. There is information about
Stanford V is the name of a combination of chemotherapy drugs used to treat Hodgkin lymphoma. You may hear it called Stanford 5 or SV. It is made up of the drugs
- Mechlorethamine (also called mustine or nitrogen mustard)
- Prednisone or prednisolone (steroids)
After your chemotherapy you may have a course of radiotherapy.
You usually have Stanford V chemotherapy as cycles of treatment. Each cycle of treatment lasts 4 weeks. You usually have 3 cycles, taking 12 weeks (3 months) in total.
You have Stanford V drugs into your bloodstream (intravenously). You can have them through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have them through a central line, a portacath or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. The tube stays in place as long as you need it.
You have the drugs as injections or drips. You have each cycle of treatment in the following way
- On the first day of treatment you have doxorubicin, vinblastine and mechlorethamine
- A week later you have bleomycin and vincristine
- A week later you have doxorubicin, vinblastine and etoposide
- On the next day you have etoposide
- 6 days later you have bleomycin and vincristine
Then you have no treatment until the next cycle starts a week later.
You take prednisolone or prednisone as tablets every other day for the 12 weeks. From the beginning of week 10 you gradually reduce your dose until you finish treatment after 12 weeks. Your doctor, pharmacist, or specialist nurse will tell you how to reduce the dose.
The side effects of a combination of drugs are usually a mixture of those of each drug. The combination may increase or decrease your chance of getting each side effect or it may change the severity.
The side effects associated with Stanford V are listed below. You can use the underlined links to find out more about each one. For general information, see our side effects of cancer drugs section.
More than 10 in every 100 people have one or more of the following effects.
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C. You will have regular blood tests to check your blood cell levels
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)
- Numbness or tingling in fingers and toes affects about 8 out of every 10 people (80%). It can cause difficulty with fiddly things such as doing up buttons. This starts within a few days or weeks and usually goes within a few months of finishing treatment
- Tiredness during and after treatment – most people find their energy levels are back to normal within 6 months to a year
- Feeling or being sick happens in just under 7 out of every 10 people (70%) but is usually well controlled with anti sickness medicines
- Constipation can be a problem with vincristine and vinblastine but is usually controlled with laxatives – tell your doctor or nurse if you are constipated for more than 3 days
- A sore mouth – about 2 to 3 days after each treatment you may have red sore skin in your mouth and mouth ulcers. These gradually clear up within a couple of weeks
- Sensitivity to sunlight – don’t sit out in the sun. Do cover up or use sun block on exposed skin
- Skin changes, including reddening or darkening of your skin
- Changes to your nails
- Hair loss – most people have complete hair loss but the hair will grow back once the treatment ends
- Your urine may become pink or red for 1 or 2 days after treatment – this is due to the colour of one of the drugs and won't harm you
- Watery eyes that may last for several days – your eyes may also be sore
- Women may stop having periods (amenorrhoea) but this may be temporary
Between 1 and 10 in every 100 people have one or more of these effects.
- Inflammation around the drip site – if you notice any signs of redness, pain, swelling or leaking at your drip site, tell your nurse straight away
- Some people have an allergic reaction while having Stanford V treatment, usually at the first or second treatment. Let your treatment team know immediately if you feel hot or have any skin rashes, itching, dizziness, headaches, shivering, breathlessness, anxiety, flushing of the face, or a sudden need to pass urine
- Taste changes
- Loss of appetite
- Loss of fertility – you may not be able to become pregnant or father a child after treatment with this drug. 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
- Damage to heart muscle from doxorubicin, which is usually temporary. For a small number of people the damage may be permanent. Your doctor or nurse will check your heart before and after your treatment
- Diarrhoea – drink plenty of fluids. Tell your doctor or nurse if the diarrhoea is severe or lasts more than a couple of days
Fewer than 1 in 100 people have these effects.
- Jaw pain
- High blood pressure
- Inflammation of the lungs – you will have lung tests before and during treatment. Tell your doctor or nurse if you have a dry cough or breathlessness, especially in cold weather
- There is a small risk that you may get a second cancer some years after Stanford V treatment
You may have 1 or 2 side effects or several. A side effect may get worse through your course of treatment. Or you may have more side effects as the course of treatment goes on. This depends on
- How many times you've had a drug before
- Your general health
- How much of the drug you have (the dose)
- Other drugs you are having
Coping with side effects
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Pregnancy and contraception
These drugs may 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.
Do not breastfeed during this treatment because the drugs may come through in the breast milk.
You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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