Oncura

ABVD: what to expect, day by day

Hodgkin Lymphoma28-day cycle7 effects documented

A curative regimen for Hodgkin lymphoma. The most important thing to watch is bleomycin's effect on the lungs — report any new breathlessness or dry cough. Nausea and hair loss are common; unusually, your team will generally keep you on schedule even if white cells dip, because infection risk stays relatively low.

Doxorubicin + bleomycin + vinblastine + dacarbazine on days 1 & 15 of a 28-day cycle. The signature risk is bleomycin's effect on the lungs (CUMULATIVE, can be serious). Notably, ABVD is usually given ON SCHEDULE at full dose even when white cells are low — fever while neutropenic is relatively uncommon and a booster is generally NOT used.

Get help straight away — this is true on any regimen, on any day.

A temperature of 100.4°F (38°C) or higher during treatment can mean a serious infection while your blood counts are low. Call your team or go to the ER — do not wait it out.

Also urgent: trouble breathing or chest pain · swelling of the face, lips or throat · new confusion or fainting · shaking chills · not being able to keep fluids down.

This is standing guidance shown to everyone. Nothing on this page is based on anything about you, and nobody is monitoring you.

2 of the 7 entries below are marked provisional. They are shown because leaving them out would be its own distortion, but they have not yet been checked against the source document by a person, and they are not presented as authoritative. Every provisional entry is labelled where it appears.

Timed to the cycle

Day 1 is the day of your infusion. These are the effects a retrievable document ties to a day range for this regimen — not a prediction about you.

Neutropenia (usually managed on-schedule)PROVISIONAL

Typically around days 10–21

White cells commonly dip, but a helpful quirk of ABVD is that treatment usually continues on schedule at full dose without a booster — fever while neutropenic is relatively uncommon. Your team still checks counts and gives fever instructions.

Call your team urgently: A temperature of 100.4°F (38.0°C) or higher — an emergency.

reported by about common% of people; severe in grade 3-4 common but low FN% · Timing from the manufacturer’s prescribing information · from Doxorubicin, Vinblastine, Dacarbazine

Not tied to a cycle day

These build with the number of doses, or are measured from when treatment started, so a cycle day would be the wrong shape for them. Each keeps the timing its own source states.

Lung inflammation / scarring (bleomycin pulmonary toxicity)PROVISIONAL

cumulative, dose/age-related; can develop over the course

Bleomycin's signature risk: inflammation of the lungs that can progress to scarring. It's dose- and age-related and can occasionally be serious or fatal. Report ANY new or worsening breathlessness, dry cough, or chest discomfort promptly — your team checks lung function and will stop bleomycin if there are signs.

Call your team urgently: New or worsening breathlessness or cough — contact your team urgently.

reported by about ~10% (Hodgkin series up to ~10-25%) of people; severe in ~1% fatal · from Bleomycin

Nausea and vomiting

Sickness in the first 24 hours is the "acute" phase and usually peaks 2-3 hours in; anything from 24 to 120 hours is the "delayed" phase.

Dacarbazine is strongly nausea-causing, so you'll get robust anti-nausea prevention before each dose. It usually eases within a day or two.

Call your team: Can't keep fluids down for more than 12 hours.

reported by about ~90% (highly emetogenic without prophylaxis) of people; severe in low with prophylaxis% · Timing from a clinical guideline · from Dacarbazine, Doxorubicin

Heart-muscle weakening (cardiotoxicity)

cumulative; can appear months-years later

Doxorubicin can weaken the heart's pumping; the risk rises with total dose (a standard ABVD course stays in a lower-risk range). Your team may check heart function; report new breathlessness or swelling.

Call your team: New shortness of breath, swelling, or a rapid/irregular heartbeat.

reported by about ~1-2% CHF at ~300 mg/m² of people · from Doxorubicin

Hair loss

begins ~2-3 weeks in

Hair loss is common and grows back after treatment ends.

reported by about common% of people · from Doxorubicin, Vinblastine, Dacarbazine

Peripheral neuropathy (milder)

builds over cycles; usually reversible

Vinblastine can cause some numbness or tingling, usually milder than with vincristine (its main dose-limiting effect is on blood counts, not nerves). Report new numbness or constipation.

reported by about less common / milder% of people · from Vinblastine

Fatigue

Tiredness that builds through the cycles and usually improves after treatment ends. Pace activities and rest.

reported by about very common% of people · from Doxorubicin, Bleomycin, Vinblastine, Dacarbazine

Where this comes from

  1. S1. Bleomycin (Blenoxane) FDA label (boxed: pulmonary fibrosis; ~10% pulmonary toxicity, ~1% fatal) — FDA label
  2. S2. Doxorubicin (Adriamycin) FDA label (cumulative cardiotoxicity) — FDA label
  3. S3. Bleomycin pulmonary toxicity (StatPearls NBK555895) + Hodgkin ABVD literature — review
  4. S4. ABVD full-dose-without-G-CSF practice (Evens/Boleti; ASCO antiemetic guideline) — review

Timing windows on this page rest on:

A window appears here only where a retrievable document ties it to a drug in this regimen. Where nothing could be found, the window was removed rather than estimated — so a missing time is an honest gap, not an oversight.

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