Thiotepa is a chemotherapy drug given before a stem-cell transplant or bone-marrow transplant. Thiotepa is used to treat leukemia, lymphoma, and myeloma.
HOW IS THIOTEPA GIVEN?
You will have thiotepa during a hospital stay. It is given in combination with other chemotherapy medications. During the treatment, your cancer specialist or hematologist will watch you closely. You will also be seen by a chemotherapy nurse or a specialist nurse.
Your nurse will give you drugs to control your nausea before the chemotherapy. Thiotepa is given in one of the following ways:
- through a fine tube that goes below the skin of your chest toward a nearby vein (central line)
- through a thin tube that is placed in a vein in your arm and then goes up toward a vein in the chest (PICC).
- Your nurse will give you thiotepa as a drip. They usually run the drip through a pump, giving you the treatment over a set time.
When the chemotherapy is administered
Some people may have side effects while they are receiving chemotherapy. This can cause allergic reactions. Your nurse will see if there are signs of this, and if you have a reaction they will treat it quickly. The signs of a reaction may include the following: rash, itchiness, reddening, or breathlessness; swelling in the face or lips; nausea; pain in the abdomen, back, or chest; or feeling unwell. Tell your nurse immediately if you have any of these symptoms. You may be given steroids to help reduce the reduce the risk of a reaction.
POSSIBLE SIDE EFFECTS OF THIOTEPA
You may experience some of the side effects mentioned here, though it is rare for a patient to have all of them. If you receive other chemotherapy drugs, you may have other side effects that are not mentioned here. Always inform your doctor of the effects you experience.
Your doctor can prescribe medication to help control some of the side effects. It is very important to take the medication exactly as your doctor says for it to have the highest chance of working well. Your nurse will advise you on managing the side effects. After treatment, the side effects start to get better.
RISK OF INFECTION
Thiotepa may lower the number of white blood cells in your blood. This will make you more susceptible to infection. Your nurse can tell you when you might have the lowest levels of these cells. When the number of white blood cells is low, this is called neutropenia.
Contact your hospital immediately if any of the following happens:
- your temperature goes above 38 ° C
- you suddenly feel unwell, even if your temperature is normal.
- You have symptoms of infection, which may include sore throat, coughing, or the need to urinate frequently.
The number of white blood cells normally increases gradually, returning to normal before your next chemotherapy session. You will have a blood test before your next chemotherapy. If your white blood cells are still low, your doctor may postpone the treatment for a short period of time.
BRUISING AND BLEEDING
Thiotepa may lower the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any unexplained bleeding or bruising. This includes nosebleeds, bleeding gums, blood spots, or skin eruptions (rashes). Some people may require additional platelets.
Thiotepa may lower the number of red blood cells in your blood. Red blood cells transport oxygen throughout the body. If you have a low number of red blood cells, you may be tired and short of breath. Tell your doctor or nurse if you feel like this. If you are very anemic, it's possible you will require a blood transfusion.
This can happen on the first few days after chemotherapy. Your doctor will prescribe you antiemetic drugs to help prevent or control your nausea. It is easier to prevent nausea than it is to treat it once it has begun.
If you still have nausea or are vomiting, get in touch with the hospital as soon as possible. They can give you advice and change your medication to one that works better.
LOSS OF APPETITE
You may lose your appetite during the treatment. Try to eat in small quantities and have frequent meals. Don't worry if you don't eat much for a day or two. If your appetite doesn't get any better after a few days, tell your nurse or dietitian. They can give you nutritional supplements or good-tasting meal-replacement drinks.
Feeling very tired is a common side effect. Fatigue is often worst toward the end of treatment and for a few months after the treatment has finished. Try to pace yourself and rest as much as you need to. Help balance this with a bit of light exercise, such as short walks. If you feel drowsy, don't drive or operate heavy machinery.
SORENESS OF THE MOUTH
You may have a sore mouth or mouth ulcers, which could make you more prone to getting a mouth infection. Lightly brush your teeth and/or dentures in the morning and night and after meals. Use a soft-bristle toothbrush. Your nurse might ask you to rinse your mouth out regularly or use mouthwash. It is important that you follow all the instructions you are given and that you drink a lot of fluids.
Tell your nurse or doctor if you have any mouth problems. They can prescribe you drugs to prevent or treat infections of the mouth and to treat any kind of pain.
Your doctor can prescribe medicines to control diarrhea. Let them know if your diarrhea is severe or if it doesn't get better. Make sure you drink at least two liters of fluids each day if you have diarrhea.
Thiotepa can cause constipation. Drinking at least two liters of fluids each day will help if this is the case. Try to eat more high-fiber foods such as fruit, vegetables, and whole-grain bread and get some light exercise.
Thiotepa can cause upset stomach. Tell your doctor if you have stomach pain or indigestion. In rare cases, thiotepa can cause stomach ulcers. Tell your medical team if you notice blood when you have bowel movements or if you pass dark stool.
Chemotherapy can affect your skin. Thiotepa can produce a rash, which may cause itchiness. If your skin is dry, try to use a fragrance-free moisturizing cream every day. Always tell your doctor about any change to your skin. These changes can be temporary, improving once the treatment is over.
Your eyes may become watery. Your doctor can prescribe eye drops to help this. If your eyes become red and inflamed (conjunctivitis), tell your doctor. This is because you may need antibiotic drops. In rare cases, thiotepa may affect your vision. Always tell your doctor or nurse about any change to your eyesight.
CHANGES IN HEARING
Some people get a ring in their ears (tinnitus). Tell your doctor if you notice any changes in your hearing.
CHANGES IN THE LIVER
Thiotepa can change the way the liver functions. These usually go back to normal once the treatment ends. You will have periodic blood tests done to see how your liver is working.
MUSCLE AND/OR JOINT PAIN
You may have pain in your joints or muscles for a few days after chemotherapy. Tell your doctor if this happens so they can prescribe you some painkillers. Let them know if your pain doesn't go away.
LESS COMMON SIDE EFFECTS OF THIOTEPA
CHANGES IN THE HEART
Thiotepa can affect the way the heart works. You may have tests done before, during, and sometimes after your treatment to see how your heart is working.
If you have pain or pressure in your chest, feel out of breath, or notice changes in your heart rate at any time during or after treatment, let your doctor know immediately. These symptoms could be caused by other conditions, but it important to have them looked at by a doctor.
CHANGES IN THE LUNGS
Thiotepa can cause changes in the lungs. Always let your doctor know if you have wheezing, coughing, fever, or if you are out of breath. If necessary, tests can be done to check your lungs.
EFFECTS ON THE NERVOUS SYSTEM
Thiotepa can affect the nervous system. You may feel anxiety or restlessness, sleepiness, or confusion. Tell your doctor or nurse immediately if you have any of these symptoms.
Thiotepa can increase the risk of developing a second cancer years down the road. Overall, however, the benefits of the treatment far outweigh this risk. Your doctor can talk to you about this.
MORE INFORMATION ABOUT THIOTEPA
BLOOD CLOT RISK
Cancer and chemotherapy increase the chances of a blood (thrombosis). The symptoms include pain, reddening or swelling in a leg, difficulty breathing, and pain in the chest. Get in touch with your doctor immediately if you have any of these symptoms.
Some medicines can interact with chemotherapy or be harmful if they are taken alongside chemotherapy. This includes medications that can be purchased in a store or pharmacy. Tell your doctor the medicines you are taking, including over-the-counter medications, complementary therapies, and herbal medicines.
Thiotepa may affect your fertility. If this worries you, you can talk to your doctor before beginning treatment.
Your doctor will advise you not to become pregnant during the treatment. This is because the drugs can harm developing babies. It is important to use contraception during chemotherapy and for a few months after the treatment ends.
If you have sex within the first few days after chemotherapy, it is necessary to use a condom. This is to protect your partner in case there is chemotherapy in semen or vaginal fluid.
Women are recommended not to breastfeed during treatment and for a few months after chemotherapy has concluded. This is in case the chemotherapy enters their breast milk.
MEDICAL AND DENTAL TREATMENT
If you have to go to the hospital for whatever reason other than cancer, always tell the doctors and nurses that you are having chemotherapy.
Talk to your cancer doctor or nurse if you think you need dental treatment. Always let your dentist know that you are having chemotherapy.