Pentostatin (Nipent)

Please read this information in conjunction with our general information on chemotherapy, and with the information in relation to your specific type of cancer.

What is Pentostatin ?

Pentostatin is a chemotherapy drug that is used to treat certain types of leukaemia's. It is most commonly used to treat hairy cell leukaemia.

 What does it look like?

It is a clear colourless fluid.

How is it given?

  • It is given as injection into a vein via a cannula.
  • It is given in the form of a drip through a cannula or central line or PICC line.

Side effects

The side effects mentioned below may not affect everyone, as each patient's reaction to chemotherapy is different. It will also depend on how many chemotherapy drugs you are receiving. If you experience any side effects that you think are related to your chemotherapy, please discuss them with your oncology doctor or chemotherapy nurse.

Infection

You will be more prone to infection as pentostatin affects your white cell production from the bone marrow. This effect usually occurs about 10-14 days after your chemotherapy. You will have blood tests to check your levels before every chemotherapy dose to ensure your blood levels have returned to normal. Occasionally your treatment may be delayed until your blood levels come back to normal. If you notice any signs of infection visit your doctor for assessment.
You should contact your doctor or the Oncology Unit straight away if you if you have a sore throat,cough, pain passing urine, redness and swelling at e.g. at a catheter site. Or have a temperature of 38 degrees° C or greater.

Bruising

Pentostatin can also affect the production of platelets, which can cause bleeding or bruising. Inform your doctor if you notice any unexplained bleeding or bruising.

Anaemia

You may feel lethargic and breathless due to a reduction in your red cells caused by pentostatin. Inform your doctor if you are feeling these effects.

Nausea and vomiting

Pentostatin   can make you feel sick nausea   or to to be sick vomit  . It may occur a few hours after you receive your first dose of pentostatin and can last for several days in some cases. Your doctor will prescribe some medications to prevent this anti-emetics  .If you continue to feel sick it is important to inform your doctor.

Skin changes

Pentostatin can cause a rash, which may be itchy. Your doctor can prescribe medicine to treat this. You may also notice spots o your face or upper body like acne. Use unperfumed soaps and moisturisers on your skin during treatment. These symptoms usually subside a few months following treatment with pentostatin. Let your doctor know if you have any skin reactions after the chemotherapy.

Fatigue

You may feel very tired. This can last for a few months after your treatment. Inform your doctor or nurse of how you are feeling.

Gritty eyes

The lining of your eye lids may become inflamed from pentostatin. If this occurs inform your doctor who can prescribe you drops to ease this symptom.

Less common side-effects

Sore Mouth

You may develop a sore mouth or ulcers due to your chemotherapy. You will be prescribed some mouthwashes. Inform your doctor or nurse if your mouth becomes sore or you develop ulcers. You may also experience some taste changes, which will resolve after you finish your treatment.

Diarrhoea

If Diarrhoea occurs it can be easily controlled with medicine. It is important to drink plenty of fluid if you experience diarrhoea and to inform your doctor or nurse.

Allergic reactions

Some patients may experience some breathlessness, headaches; back pain, skin rash or facial swelling once the drug has been given. If you experience any of these effects tell your doctor or nurse immediately. You will be monitored very closely for signs of allergic reaction during your treatment. You may receive a drug before your chemotherapy to prevent this allergic reaction occurring.

Liver problems

Pentostatin may alter the way the liver works. Once the treatment has finished your liver function will return to normal. Your doctor will monitor your liver function very closely while you are on treatment by checking your bloods but this temporary disturbance to your liver function is very unlikely to cause you harm.

Lung changes

In rare cases pentostatin may cause changes to the lung tissue. If you notice any breathlessness or unusual symptoms inform your nurse or docor immediately.

Kidney problems

Your kidneys may be affected by large doses of pentostatin. Your doctor will monitor your kidney's closely during and before each treatment with a blood and urine test.

Hair loss

If hairloss is going to occur it usually will occur 2-4 weeks after the first dose of treatment. The usual effect on a persons hair is thining of the hair but in rare cases the hair may be lost completely. You may also have loss of hair or thining of your eyebrows, eyelashes and other body parts. It is important to remember that this hair loss is just temporary and hair will regrow once treatment stops.

Additional information

Phlebitis

You may experience a pain or swelling at the injection site cannula in you hand or arm while you are having your pentostatin treatment. You should inform your nurse or doctor if this occurs.

Other medications

It is important to inform your doctor of any medications that you are taking, including over the counter medications or herbal drugs as they can interfere with some chemotherapy drugs.

Fertility

It is important to discuss this with your doctor as your fertility may be affected by pentostatin.

Contraception

It is important to use a reliable form of contraception while you are on treatment and for at least two years after your treatment has completed. It is not advised to get pregnant or father a child while on treatment as the drugs may affect the foetus.

References:

  • British National Formulary (53rd edition). British Medical Association and Royal Pharmaceutical Society of Great Britian, March 2007.
  • The Chemotherapy Source Book (2rd edition). Ed. Perry. Lippincott Williams and Wilkins, 1997.

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