Thiotepa

Thiotepa is a chemotherapy drug used to treat ovarian cancer, bladder cancer, Hodgkin's lymphoma and high grade non Hodgkin's lymphoma. It is one of a group of drugs called alkylating agents. These work by sticking to one of the cancer cell's DNA strands. The cell cannot then divide into 2 new cells. DNA is the genetic code that is in the heart of all animal and plant cells. It controls everything the cell does. 

Thiotepa is a clear liquid that you can have in a number of different ways

• By injection through a fine tube (cannula) put into a vein (intravenously)
• Through a central line put into a vein near your collarbone
• By injection into a muscle (intramuscular)
• Directly into the bladder (intravesically)

You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for thiotepa depends on which type of cancer you have. There is detailed information about how doctors plan chemotherapy in CancerHelp UK.

Thiotepa side effects are listed below. You can use the links to find out more about each side effect or click on search at the top of the page.

More than 10 in every 100 people have one or more of the side effects listed below.

Temporary drop in the number of blood cells made by the bone marrow, causing

• 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, sore throat, pain passing urine or feel cold and shivery
• 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)

Some of these side effects can be life threatening, particularly infections. You should contact your doctor if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

• Fatigue during and after treatment – most people find their energy levels are back to normal within 6 months to a year
• Women may stop having periods (amenorrhoea) but this may only be temporary
• Thiotepa may harm a developing baby so it is not advisable to become pregnant or father a child if you are having this drug – talk about contraception to your doctor before having the treatment if there is any chance you or your partner could become pregnant
• Loss of fertility – you may not be able to get pregnant or father a child after treatment so it is important to talk to your doctor about your fertility before starting treatment if having a baby is important to you

Between 1 and 10 in every 100 people have one or more of these.

• Skin changes such as a rash, itching, darkening or flaking of your skin – these will disappear within a few months of finishing treatment
• Allergic reaction – tell your doctor or nurse straight away if you have a sudden cough or have wheezing, difficulty breathing, itching or a rash
• Feeling or being sick is usually moderate and most likely to start within 12 hours of having treatment – this is usually easily controlled with anti sickness injections and tablets, so tell your doctor if you still have sickness as there will be other medicines you can try
• Hair usually thins but complete hair loss is very rare

Fewer than 1 in 100 people have these.

• Thiotepa directly into the bladder (intravesically) can irritate the lining and make you want to pass urine more often (cystitis) – your doctor or nurse can give you medicines to ease this
• There is a small risk that you may get a second cancer some years after thiotepa treatment

With high dose thiotepa before a bone marrow or stem cell transplant, you may have

• Drowsiness
• Fits (seizures)
• A sore mouth
• Diarrhoea
• A skin rash

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse, clinic or ward nurse will give you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together. 

You should not have immunisations with live vaccines while you are having this treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines 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.