Below is a list of drugs that may be used during transplantation along with some of the more common side effects associated with them. Each patient responds differently to each drug. All patients do not receive all of these drugs. The particular combination of drugs you will receive and whether or not you will be given radiation, will be carefully reviewed with you prior to transplantation.
- CYTOXAN (CYCLOPHOSPHAMIDE) - This drug may cause nausea and vomiting. In approximately one week to ten days it will cause hair to fall out. It can also cause hemorrhagic cystitis (bleeding from the bladder). To reduce the risk of cystitis, patients who receive this drug will have a catheter placed in their bladder. This catheter will be continuously flushed with saline for 24 hours after this drug is given. A rare side effect of Cytoxan is weakening of the heart muscle. In its worst form, this weakening may cause heart failure and death in less than 1% of patients who have an otherwise healthy heart.
- IFOSPHAMIDE - This drug is a close relative of Cytoxan and produces some of the same nausea, vomiting, and hair loss. It has a greater tendency to cause bleeding of the urinary bladder. However, this can be almost completely prevented by simultaneous infusion of a drug called MESNA.
- ARA-C or CYTARABINE - This drug is excreted through tears and may cause conjunctivitis or reddening of the white part of the eye. To prevent this, eye drops are given while this drug is being used. Other possible side effects are nausea, vomiting, skin rash, and hair loss. A rare side effect of Ara-C may be a temporary or permanent disturbance of the brain resulting in difficulty with balance or speech and slowness of movement.
- BCNU - This drug may cause nausea and vomiting. Infrequently, it may cause liver inflammation or lung inflammation and scarring.
- VP-16 or ETOPOSIDE - This drug may cause nausea, vomiting, and diarrhea. It may also cause hair loss or, uncommonly, temporary problems with blood pressure. Mouth sores occur in over half of patients.
- CIS PLATINUM - This drug may also cause nausea and vomiting. It can also affect the hearing and the kidneys. Infrequently, it may affect the nervous system, causing spontaneous pain syndromes, particularly in the lower extremities.
- CARBOPLATIN - This drug is a very close relative of cis-platinum causing, in general, much less in the way of gastrointestinal upset, kidney damage, or hearing problems. It, therefore, can be used in higher doses than cis-platinum. Carboplatin has been associated with damage to sensory nerves, particularly in the hands and feet, causing an uncomfortable or painful burning sensation that may last several months.
- THIOTEPA - This drug is related to Cytoxan in the way it works but generally causes little stomach upset. Mouth sores and peeling of the skin (as would happen with a sunburn) occasionally will happen. At high doses a temporary sluggish behavior may be seen.
- BUSULFAN - This drug is a particularly powerful anti-leukemia or lymphoma medication and is most often used when total body irradiation is not to be used. It continues to be manufactured as a 2 milligram tablet which means, that for transplantation purposes, a large number of tablets have to be taken (for example, 35 tablets four times per day for four days). Most patients are able to take this medication with little in the way of immediate side effects. Serious side effects which occur in less than five percent of patients are lung damage or blood vessel damage in the liver. As a consequence, a few patients may experience life-threatening or fatal lung or liver injury.