Treatment Name: BV-CHP (Brentuximab Vedotin (Adcetris®) + Cyclophosphamide + Doxorubicin + Prednisone)
BV-CHP (Brentuximab Vedotin (Adcetris®) + Cyclophosphamide + Doxorubicin + Prednisone) is a Chemotherapy Regimen for Lymphoma, T-Cell
How does BV-CHP work?
Brentuximab vedotin is an antibody that specifically targets T-cell lymphoma cells. Once it binds to the lymphoma cell surface, it then enters the inside of this cancer cell. Once inside the cell, the antibody releases a drug called MMAE, which stops the cancer cell from growing and dividing.
Each of the medications in CHP, as shown below, also help to kill cancerous T-lymphocytes.
BV – Brentuximab Vedotin (Adcetris®)
C – Cyclophosphamide (Cytoxan®)
H – Hydroxydaunorubicin (Doxorubicin)
P – Prednisone
Alternative names: A + CHP, brentuximab vedotin + CHP, brentuximab + CHP
Goals of BV-CHP therapy:
BV-CHP is given to shrink T-cell lymphoma and reduce symptoms caused by the lymphoma. BV-CHP is commonly given with the goal of cure.
How is BV-CHP therapy for T-cell lymphoma given?
- Brentuximab vedotin intravenous (I.V.) infusion over 30 minutes on Day 1
- Cyclophosphamide (Cytoxan) I.V. infusion over 30 to 60 minutes on Day 1
- Hydroxydaunorubicin (doxorubicin) I.V. push or I.V. infusion over 15 minutes on Day 1
- Prednisone 100 mg (two 50 mg oral tablets) by mouth on Days 1, 2, 3, 4, and 5
Estimated total infusion time for this treatment:
- Up to 2 hours for Day 1 of each Cycle
- Infusion times are based on clinical studies but may vary depending on doctor preference or patient tolerability. Pre-medications and intravenous (I.V.) fluids, such as hydration, may add more time
BV-CHP is usually given in an outpatient infusion center, allowing the person to go home afterwards. On occasion, it may be given in the hospital if someone is too sick.
BV-CHP is repeated every 21 days. This is known as one Cycle. Each cycle may be repeated up to 8 times. Duration of therapy may last up to 6 months, depending upon response, tolerability, and number of cycles prescribed.
Click here for the common BV-CHP starting doses for T-cell lymphoma.
What are the most common side effects from BV-CHP for T-Cell lymphoma?
In a multi-drug regimen, each medication has unique side effects. When these medicines are given together, drug-related side effects reported in clinical studies give the best estimate of what to expect. In clinical studies, the most commonly reported side effects of BV-CHP are shown here:
On average, 6% of patients discontinue BV-CHP treatment due to unacceptable side effects.
Importantly, not all people who experience a side effect from BV-CHP will experience it in the same way. It may be mild in some or severe in others, depending upon the individual. Everybody is different. Additionally, side effects may vary over time. For some, side effects may be a reason to delay or switch treatment, reduce the dose, or avoid treatment with a certain medication altogether.
Side effects may be treatable when they occur or preventable by taking certain medications before they happen. When medications are taken to prevent a problem, this is known as prophylaxis, or "prophy" for short.
After starting treatment with BV-CHP, be sure to come back and watch all of the side effect videos shown below. Each of these videos contain valuable information about side effect management that will hopefully help you to both feel better and stay out of the hospital.
Watch videos on common BV-CHP therapy side effects below
How often is monitoring needed with BV-CHP treatment?
Labs (blood tests) may be checked before each treatment. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), Lactate Dehydrogenase (LDH), blood phosphorous levels, uric acid levels, plus any others your doctor may order.
How often is imaging needed with BV-CHP treatment?
Imaging may be checked before treatment and after 3 to 4 cycles to determine how well the chemotherapy is working or at the discretion of your doctor if there are concerns for certain side effects. Imaging may include: X-rays, magnetic resonance imaging (MRI), computerized tomography (CT) scans, or positron emission tomography (PET) scans.
How might blood test results/imaging affect with BV-CHP treatment?
Depending upon the results, your doctor may advise to continue BV-CHP as planned, reduce the dose of future treatments, delay the next treatment until the side effect goes away, or switch to an alternative therapy.
- Filgrastim or pegfilgrastim is recommended after each chemotherapy cycle to stimulate production of white blood cells, avoid periods of low white blood cell count (neutropenia), and prevent neutropenic fever
- Infusion reactions are rare but can occur. The most common infusion-related reactions are chills, nausea, trouble breathing, itching, fever, and cough. If infusion reactions are experienced, premedications can be given before future doses of brentuximab vedotin (Adcetris)
- Tell your doctor if you have numbness, tingling, burning, or weakness in hands or feet as this may require a decrease in brentuximab dose or delaying future doses
- Don't forget take your oral prednisone on Days 1 - 5 of each cycle! This is part of the anti-cancer therapy and also helps prevent nausea and vomiting with this regimen. Your doctor will give you a prescription to fill at your outpatient pharmacy
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for T-cell lymphoma. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for BV-CHP (Brentuximab Vedotin (Adcetris®) + Cyclophosphamide + Doxorubicin + Prednisone), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for BV-CHP (Brentuximab Vedotin (Adcetris®) + Cyclophosphamide + Doxorubicin + Prednisone). Depending upon your income, they may be able to help cover the cost of:
- Brentuximab Vedotin
- Cyclophosphamide IV
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as BV-CHP (Brentuximab Vedotin (Adcetris®) + Cyclophosphamide + Doxorubicin + Prednisone) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with BV-CHP (Brentuximab Vedotin (Adcetris®) + Cyclophosphamide + Doxorubicin + Prednisone)