bendamustine

Bendamustine (Treanda) commonly causes low blood cell counts. Sometimes, your blood cell counts can drop dangerously low. Most times, they drop to their lowest in the third week of treatment.

To help keep you safe, your oncologist will check your blood count often. They’ll also check before each new treatment cycle to make sure bendamustine (Treanda) is safe for you. If your blood cell counts are too low, your oncologist might delay the infusion until your labs get back up.

Look out for signs and symptoms of a low blood cell count. When your white blood cell count is low, you’re at risk of infection because your body can’t fight it as well. You might also feel more tired than usual when your red blood cell count is low. And, it might be easier for you to bleed or bruise with a low platelet count. If you have fever, severe tiredness, or unexplained bruising or bleeding, let your care team know.

People taking bendamustine (Treanda) have a higher risk of infections, which can sometimes be serious. These can include infections like pneumonia or sepsis. Old infections, such as tuberculosis (TB), hepatitis B, or shingles, can also come back.

Before starting bendamustine (Treanda), tell your oncologist about any past or ongoing infections. You might need to get them treated first.

During treatment with bendamustine (Treanda), your oncologist might give you antibiotics or antiviral medications to help prevent infections. Still, watch closely for signs of infection. Get medical help right away if you have a fever that’s 100.4ºF or higher, chills, or weakness.

• Risk factors: Taking with rituximab (Rituxan) or Gazyva (obinutuzumab)

Rarely, some people developed a serious brain problem after taking bendamustine (Treanda). This problem is called progressive multifocal leukoencephalopathy (PML). It’s caused by a virus that can be very dangerous for people with a weak immune system, like those taking bendamustine (Treanda).

Symptoms of PML can include weakness and clumsiness. It can also cause trouble walking or speaking. If you notice any of these symptoms, call your oncologist right away so you can get checked out.

Some people have had uncomfortable reactions during their bendamustine (Treanda) infusion. These infusion reactions can include fever, chills, itching, and rash. Rarely, reactions can be severe and cause anaphylaxis. These reactions can happen during any treatment cycle. Let your nurse know right away if you have symptoms of a reaction during your infusion.

If you have a mild reaction, your oncologist might prescribe medications for you to take before your next infusions to prevent another reaction. These medications can include diphenhydramine (Benadryl), acetaminophen (Tylenol), and steroids. If you have a severe reaction, you might need to stop taking bendamustine (Treanda) completely.

People taking bendamustine (Treanda) have had a reaction called tumor lysis syndrome (TLS). This happens when many cancer cells are destroyed quickly. This can cause high levels of potassium and uric acid in the blood, which can lead to serious heart or kidney problems.

If you develop TLS, it most often happens during the first cycle of bendamustine (Treanda). To keep you safe, your oncologist will monitor you closely during treatment. They might give you extra fluids or medications to help prevent serious problems from TLS.

• Risk factors: Taking with other cancer medications | Taking with allopurinol (Zyloprim)

Rarely, some people had had serious skin reactions while taking bendamustine (Treanda). These reactions can sometimes be life-threatening. Examples include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS).

Watch for signs of serious skin reactions while taking bendamustine (Treanda). They can look like a rash, painful blisters, open sores, peeling skin, or a fever. If this happens, get medical help right away. If the reaction is severe or keeps getting worse, you might need to stop bendamustine (Treanda).

• Risk factors: Taking with other cancer medications | Hepatitis B infection

Some people taking bendamustine (Treanda) have had serious and sometimes life-threatening liver problems. Most cases happened during the first 3 months of treatment.

To be safe, your oncologist will check your liver with blood tests before you start bendamustine (Treanda) and during treatment. Most times, you won’t feel symptoms when your liver is irritated. But tell your oncologist right away if you notice yellowing of your skin or eyes, stomach pain, or swelling in your belly. These can be signs of liver problems.

Although it’s not common, some people who took bendamustine (Treanda) later developed new cancers. These included blood cancers like myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Others were lung cancer and skin cancers.

Your oncologist will keep checking on you for signs of new cancers, even after you stop treatment. Watch for unusual skin changes, such as spots that change size or color. If you notice any new symptoms or unusual skin spots, call your oncologist or primary care provider right away.

Bendamustine (Treanda) can sometimes leak out into the surrounding tissues from the IV line. This can cause irritation, like burning pain and swelling, and tissue damage.

To prevent this, your oncologist might recommend a certain type of IV access device, such as a port. But still watch out for any redness, swelling, pain, burning, or warmth during and after your bendamustine (Treanda) infusion. If this happens, tell your nurse right away.

• Risk factors: Pregnancy

Based on animal studies and how the medication works, bendamustine (Treanda) can harm an unborn baby. If you can have a child, your oncologist might ask you to take a pregnancy test before starting treatment to make sure you aren’t pregnant.

If you can get pregnant, also use effective birth control while taking bendamustine (Treanda) and for 6 months after your last dose. If you’re a man who can father a child, use birth control, like condoms, during treatment and for 3 months after stopping the medication. Tell your oncologist right away if you or your partner becomes pregnant.