[Thelimeusa]

Modified CVAD

by Thelimeusa on Sat Dec 14, 2013 11:04 am

My wife is getting this in the hospital next week. Can anyone tell me what to expect and how I can help her. I helped her with her Auto by making sure she sucked on ice 30 mins. Before her high dose chemo. How can I help her this time to lessen symptoms?

[Cheryl G]

Re: Modified CVAD

by Cheryl G on Sat Dec 14, 2013 3:43 pm

Not sure I know what modified CVAD is. I've seen modified hyper-CVAD, but not plain modified CVAD.

Are you sure your wife is going to get "modified CVAD", or is it "modified hyper-CVAD"?

These are two good resources that explain more about what standard (not modified) hyper-CVAD is:

http://en.wikipedia.org/wiki/Hyper-CVAD

http://www.nhs.uk/ipgmedia/national/macmillan%20cancer%20support/assets/hyper-cvadmcs7pages.pdf

As for "modified hyper-CVAD", see Figure 1 in this article,

http://bloodjournal.hematologylibrary.org/content/104/6/1624.full.pdf

which gives a sketch of the regimen.

In hyper-CVAD, there are alternating two different types (rounds) of therapy that rotate.

In the odd rounds (round 1, 3, 5, etc.), you get cyclophosphamide, vincristine, Adriamycin (doxorubicin), and dexamethasone (CVAD).

In the even rounds, you get methotrexate and cytarabine.

In modified hyper-CVAD, it looks like there are three different types of therapy rounds.

Rounds 1, 4, 7, etc. are once again CVAD.

Rounds 2, 5, 8, etc. are DaunoXome (liposomal daunorubicin) and cytarabine.

And rounds 3, 6, 9, etc. are methotrexate and cytarabine.

All in all, this seems to be relatively intensive therapy, using lots of different drugs, most of them older chemotherapy drugs.

[elizabethmwm]

Re: Modified CVAD

by elizabethmwm on Sun Dec 15, 2013 9:02 pm

I had modified CVAD in October 2012. I was diagnosed in August 2012 and wasn't tolerating the RVD regimen (counts were too low, fever every day, 2 hospitalizations, etc). For me the process was a 4 day (4 drug) continuous IV infusions through a pic line in my arm. I was closely monitored by the nurses. Physically, I tolerated it very well with a couple of side effects (high blood sugar which they gave me insulin; high blood pressure which they gave me a pill to lower). Of, course labs every day. As soon as the process was completed, I was discharged.

Side effects after the process were diarrhea, loss of appetite and some weight loss but they didn't last too long. Started losing my hair about 3 weeks later (eventually just shaved my head). A few weeks later, I started the RVD regimen again and tolerated it with no problems (a little craziness from the dex).

The modified CVAD really "knocked back" my myeloma and that's what the doctor wanted to see. I was really nervous before going into it, but it was OK. Hope it goes well for you.

Let me know if you have any questions. I can try to answer.

[Thelimeusa]

Re: Modified CVAD

by Thelimeusa on Tue Dec 17, 2013 10:46 am

Thanks so much for both responses. Had to rush wife to the hospital Saturday due to a blood infection. She is doing well and should start the MCVAD tomorrow. Hope her experience with it is similar to what you experienced Elizabeth. She needs her numbers to come down before they give her a non related Allo Transplant.