A 40-year-old male complained about enlarged/swollen lymph nodes in the neck reg

Question

A 40-year-old male complained about enlarged/swollen lymph nodes in the neck region and underarms with intermittent fevers and night sweats. Biopsy of the tissue suggested the presence of Hodgkin’s lymphoma. The standard therapeutic regimen for Hodgkin’s lymphoma is known as the ABVD regimen (doxorubicin [ADRIAMYCIN], bleomycin, vinblastine, and dacarbazine).

a. Describe the mechanism of action of each agent in the ABVD regimen?

b. How is using a combination of cytotoxic drugs such as the ABVD regimen benefits over the purpose of single-agent therapies?

c. What could be the possible primary toxicities of the regimen?

Explanation / Answer

a. Doxorubicin has its mechanism of action as it interacts with DNA and inhibits macromolecular biosynthesis.It inhibits the progression of topoisomerase II. Bleomycin inhibits DNA synthesis. Vinblastine has antitumor activity which works through inhibition of mitosis at metaphase through its interaction with tubulin. Dacarbazine has its cytotoxic effects through alkylating agent.

b.  The advantage of combination therapy is that it employs cumulative dosing of each agent and reduces the long-term side effects.

c. Some of the possible primary toxicities of the regimen are myocardial ischemia, liver function impairment, pulmonary fibrosis and serious marrow inhibition.

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