Treanda-Bendamustine

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

Description Your treatment is called bendamustine (ben-da-MUS-teen) or Treanda® (tree-AN-da). It is commonly used to treat chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL), and has also been used to treat other diseases. It is not known exactly how bendamustine works, but it is thought to stop the growth of and kill abnormal cancer cells.

What Do I Need to Know Before Starting Treatment?

  • Be sure to tell your healthcare provider about any prescription or over-the-counter products you are taking, including dietary supplements, vitamins, herbal medicines and homeopathic remedies.
  • Use an effective birth control method while you are being treated. Bendamustine can cause harm to a fetus, so be sure to tell your healthcare provider right away if you or your partner become pregnant.
  • Avoid breastfeeding during treatment. It is not known if bendamustine passes into breast milk.
  • Some drugs can cause sterility. Talk with your healthcare provider about your options if you want to have children in the future.
  • Do not get any immunizations or vaccinations while you are being treated without the approval of your healthcare provider.
 

What Do I Need to Know Before Starting Bendamustine?

  • Bendamustine can cause an allergic reaction when it is being injected into your vein. Tell your healthcare provider if you begin to feel feverish, have chills, itchy skin or a rash. You will be monitored for these side effects while you are receiving the medication.
  • Bendamustine can cause a side effect called tumor lysis syndrome. Tumor lysis syndrome occurs when too many cancer cells die at once. This can damage your kidneys and other organs in your body. You may be given a medication to help prevent this side effect. Be sure to drink plenty of water or other non-caffeinated beverages during the first few weeks of your treatment.
  • Bendamustine can cause skin reactions. If you develop a rash or open sores, tell your healthcare provider. If this side effect occurs, you may need to stop your treatment temporarily (See “What Are the Possible Side Effects”).
  • In rare cases, bendamustine can cause secondary cancers or leukemia years after treatment.
  • Tell your healthcare provider if you have a history of liver or kidney disease. This may affect the dose of bendamustine you receive.
Your treatment can interact with other substances, including:
  • Fluvoxamine (Luvox?)
  • Ciprofloxacin (Cipro? or Proquin XR?)
  • Mexiletine or propafenone (Rythmol?)
  • Zileuton (Zyflo?) or theophylline (Theolair?, Elixophyllin?, Theo-24?, Theochron? or Uniphyl?)
  • Omeprazole (Prilosec? or Zegerid?) or lansoprazole (Prevacid? or Prevpac?)
  • Caffeine
  • Cigarettes
Please note this list is a summary and does not contain all possible drug interactions. Contact your healthcare provider if you are taking any medications that can interact with your treatment.  

Who Should Not Take This Treatment

You should not take this treatment if you are allergic to bendamustine or any components of this drug.

How Is the Treatment Given?

  • Bendamustine is given by injection into a vein. The dose you receive will be based on your weight and height. Your healthcare provider will determine how often you will receive bendamustine and the total number of treatments you will receive.
  • You may be given medicines to help prevent and control nausea and vomiting before you receive your treatment. These medicines may be given either by mouth or by injection into a vein.
 

When Should I Call My Healthcare Provider?

Call your healthcare provider right away if you have any of the following symptoms:
  • Shaking chills or fever of 100.5 degrees F or higher
  • Vomiting that is severe or that lasts several hours
  • Inability to eat or weight loss
  • Chest pain, chest tightness, shortness of breath or a severe cough
  • Dizziness or feeling lightheaded
  • Unusual bleeding, easy bruising or pinpoint red spots on your skin
  • Diarrhea that causes an additional four bowel movements a day, diarrhea that lasts more than one day, diarrhea at night or diarrhea with fever, cramps or bloody stools
  • Pain, redness, swelling or sores in your mouth or throat that interfere with eating
  • Painful or frequent urination or blood in your urine
 

What Are the Possible Side Effects?

All drugs can cause side effects, but every person reacts differently to each drug. The following chart lists the possible side effects that can occur with your treatment, how to recognize and minimize symptoms and possible treatments. The side effects are grouped by how often the side effect occurs: Common (occurs in more than 25 percent of patients), Less Common (occurs in 5 to 25 percent of patients) or Rare (occurs in less than 5 percent of patients).

Side Effect

How to Minimize Side Effect

Possible Treatments

Risk of Infection (Common with NHL. Rare with CLL.)
  • Fever and chills
  • Painful urination
  • Sore throat and cough
  • Nasal congestion
  • Swelling or redness of the skin at the site of a wound
 
  • Wash your hands often.
  • Brush and floss your teeth daily.
  • Clean cuts right away with warm water, soap and antiseptic.
  • When your white blood cell count is low, stay away from crowds and people with colds or other illnesses.
  • You may be given medicine to increase your white blood cell count.
  • You may be given an antibiotic to treat or prevent infection.
  • Your healthcare provider may decrease your dose or delay further treatment.
Anemia (Less Common)
  • Fatigue or weakness
  • Dizziness
  • Pale skin
  • Feeling out of breath
  • Feeling cold
  • Plan rest periods throughout the day.
  • Organize daily activities so that you conserve your energy.
  • Try to eat a well balanced diet and drink plenty of fluids.
  • Stand up slowly to avoid getting dizzy.
  • You may be given medicine to increase your red blood cell count.
  • Your healthcare provider may decrease your dose or delay further treatment.
Risk of Bleeding (Less Common)
  • Unusual bleeding or easy bruising
  • Black or tar-like stools
  • Blood in your urine
  • Pinpoint red spots on your skin
  • Bleeding gums or nosebleeds
  • Avoid aspirin and aspirin-like drugs, such as ibuprofen.
  • Use caution with sharp objects, such as razors and nail cutters.
  • Avoid activities that can cause cuts, bumps and bruises.
  • You may be given medicine to increase your platelet count.
  • Your healthcare provider may decrease your dose or delay further treatment
Nausea/Vomiting (Common with NHL. Less Common with CLL. Symptoms are generally mild to moderate.)
  • Feeling queasy or sick to your stomach
  • Eat small, frequent meals and bland foods— such as bananas, rice, applesauce and toast.
  • Eat food cold or at room temperature so the smell of food will not bother you.
  • Avoid fried, spicy or fatty foods.
  • Eat and drink slowly.
  • Drink plenty of liquids during the day, but to avoid bloating, drink small amounts of liquid during meals.
  • You will be given medicine to help reduce nausea and vomiting.
Anorexia or Appetite Loss (Less Common with NHL. Frequency unknown with CLL. Symptoms are generally mild.)
  • Not having an appetite
  • Feeling too nauseated to eat
  • Metallic or medicinal taste
  • Change in taste causing dislike for certain foods
  • Try eating six to eight small meals or snacks each day instead of three larger meals.
  • Vary your diet and try new foods and recipes.
  • Take a walk before meals, when possible. This may make you feel hungrier.
  • Eat with friends or family. When eating alone, listen to the radio or watch TV.
  • Cook dinners ahead of time and freeze them in small portions so that cooking smells are minimized.
  • Let others help with food, but ask that foods be prepared in small portions that can be frozen. And don’t hesitate to let them know which foods to avoid.
  • Add mild spices to change flavor.
  • It might be helpful to have a program, such as Meals on Wheels, deliver food to you.
Diarrhea (Common with NHL. Less Common with CLL. Symptoms are generally mild, but can be moderate.)
  • Loose or watery stools several times a day
  • Abdominal cramping, gas and bloating
  • Eat small, frequent meals and bland foods— such as bananas, rice, applesauce and toast.
  • Avoid caffeine; alcohol; raw fruits and vegetables; raw eggs; undercooked meats; spicy, fatty and greasy foods; milk and dairy products; foods that cause gas, such as beans and other legumes; high fiber and high-fat foods; foods left un-refrigerated for more than two hours (one hour for egg dishes and cream or mayonnaise-based foods); bulk laxatives; and stool softeners.
  • Drink eight to ten glasses of clear liquids every day.
  • Your healthcare provider may prescribe medicine to help treat diarrhea.
Constipation (Common with NHL. Less Common with CLL. Symptoms are generally mild, but can be moderate.)
  • No bowel movement for one to two days
  • Small, hard, dry stools
  • Bloating, gas, cramps and pain
  • Drink plenty of fluids to help loosen your bowels.
  • Drink warm or hot liquids if you do not have mouth sores.
  • Your healthcare provider may suggest eating foods that are high in fiber, such as bran, vegetables, whole wheat breads and fruit.
  • Have prunes or prune juice, which act like laxatives.
  • Exercise can help loosen bowels.
  • Your healthcare provider may recommend a stool softener.
Mouth Sores and Pain (Less Common. Symptoms are generally mild, but can be moderate.)
  • Pain, swelling or redness of the mouth, tongue and throat
  • “Coated tongue”
  • Difficulty talking, swallowing or eating
  • Bleeding ulcers and infection
 
  • Brush teeth two to four times a day using a soft bristle brush and fluoride toothpaste.
  • Use non-waxed dental floss daily.
  • Ask your healthcare provider to recommend a mouthwash that does not contain alcohol.
  • Sip water during the day and use sugar-free candy or gum to keep your mouth wet.
  • Eat food cold or at room temperature.
  • Eat soft or pureed food.
  • Avoid food that is acidic, spicy, salty, dry or rough, such as toast.
  • You may be given medicine to help treat pain.
  • You may be given medicine to treat fungal or viral infections.
Rash (Less Common. Symptoms are generally mild to moderate, but can be severe.)
  • Usually mild and short-lived
  • Generally appears on the arms and trunk (occasionally on the face)
  • May be itchy
  • May appear as a flat, discolored area on the skin or as a small raised bump
 
  • Avoid prolonged exposure to heat.
  • Use creams or moisturizers regularly. Try wearing cotton gloves on your hands.
  • Avoid using perfume, cologne or aftershave since these products can be irritating to the skin.
  • Your healthcare provider may prescribe creams (mild steroids, antihistamines or antibiotics) to help treat the rash.
  • The rash may improve on its own without any treatment.

Alopecia or Hair Loss (Less Common with NHL. Frequency Unknown with CLL. Hair loss is usually mild.)

  • More than normal amount of hair loss in your brush, in the shower or on your pillow after sleeping
  • Loss of body hair
Alopecia cannot be prevented but here are tips to help with hair loss:
  • Use a soft hairbrush. Do not use brush rollers, color treat your hair or get a permanent.
  • Avoid daily hair washing, use a mild shampoo and avoid using a hairdryer, or use a low setting if you must use one.
  • Have your hair cut short; this will make it look fuller.
  • Your insurance might cover a wig. Ask your healthcare provider for a prescription for a “hair prosthesis”. Your hair color and style can be better matched if you shop for a wig before losing a lot of hair.
  • Use sunscreen or wear a hat or scarf to protect your scalp from the sun.
 

What Are the Other Possible Side Effects?

The chart below lists additional side effects found with this treatment. It does not list all possible side effects. For more information, talk with your healthcare provider.

Common Side Effects with NHL

Less Common Side Effects with NHL

Rare Side Effects with NHL

  • Cough
  • Headache
  • Back pain
  • Dehydration
  • Stomach reflux or indigestion
  • Insomnia
  • Taste changes
  • Joint or bone pain
 

Common Side Effects with CLL

Less Common Side Effects with CLL

Rare Side Effects with CLL

  • Yellowing of the skin
  • Weakness
  • Headache
  • High blood pressure
  • Cough