Non-Hodgkin's Lymphoma - Chemotherapy

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• Nausea and vomiting -- Drugs known as serotonin antagonists, such as ondansetron (Zofran) or granisteron (Kyril), can relieve these side effects in nearly all patients given moderate drugs and most patients who take more powerful drugs.
• Diarrhea
• Hair loss
• Weight loss
• Depression

These side effects are nearly always temporary. Most patients are able to continue with normal activities for all but perhaps a few days a month.

Serious Side Effects. Serious side effects can also occur and may vary depending on the specific drugs used. They include the following:

• Neutropenia is a severe drop in white blood cells. Neutropenia increases the chance for infection from suppression of the immune system. White blood cell count may be improved with the addition of a drug called granulocyte colony-stimulating factor (filgrastim, pegfilgrastim, and lenograstim). There is no evidence that these drugs have any effect on survival or cancer recurrence.
• Anemia is a lack of red blood cells. Erythropoietin stimulates red blood cell production and can help reduce or prevent this side effect. It is available as epoetin alfa (Epogen, Procrit) and darbepoetin alfa (Aranesp). Aranesp persists longer in the blood than epoetin alfa and requires fewer injections.
• Liver and kidney damage
• Abnormal blood clotting (thrombocytopenia)
• Allergic reaction

Long-Term Complications.

• Fatigue and Somatic Symptoms. Chemotherapy has been associated with long-term somatic symptoms, which are general conditions, such as fatigue and aches and pains that have no apparent physical basis. Fatigue is especially common after chemotherapy and can even last for years.
• The most serious long-term complications from chemotherapy are secondary cancers, particularly in people over age 40.
• Infertility is also a danger, particularly with the use of cyclophosphamide.
• Some patients report osteoporosis and damage in bone cells, possibly related to corticosteroid treatments.
• Regimens containing certain drugs, particularly doxorubicin or mitoxantrone, increase the risk for future heart failure.