Tumour lysis syndrome
Some people having treatment for cancer can develop Tumour Lysis Syndrome (TLS), which results from the fast breakdown of cancer cells especially during the first couple of weeks of treatment. As the cancer cells are destroyed, they break open and the content of the cancer cell (uric acid, potassium, phosphorus) gets into the blood. This can lead to changes in kidney function, sudden kidney failure or even death.
If you do not have any heart or kidney problems, keep your fluids up by drinking at least 8 to 10 glasses of fluid daily. It is also important for you to keep your scheduled appointments for blood tests.
Changes to your dose or treatment delays
Sometimes a treatment may be started at a lower dose or the dose needs to be changed during treatment. There may also be times when your treatment is delayed. This can happen if your doctor thinks you are likely to have severe side effects, if you get severe side effects, if your blood counts are affected and causing delays in treatment, or if you are finding it hard to cope with the treatment. This is called a dose reduction, dose change or treatment delay. Your doctor will explain if you need any changes or delays to your treatment and the reason why.
Central venous access devices (CVADs)
This treatment may involve having chemotherapy through a central venous access device (CVAD). Your doctor or nurse will explain this to you. For more information see the eviQ patient information sheets on CVADs.
Blood tests and monitoring
Anticancer drugs can reduce the number of blood cells in your body. You will need to have regular blood tests to check that your blood cell count has returned to normal. If your blood count is low your treatment may be delayed until it has returned to normal. Your doctor or nurse will tell you when to have these blood tests.
Medications for blood pressure
Rituximab may lower your blood pressure. Tell your doctor if you are taking any blood pressure medications. Your doctor may advise you to temporarily stop your blood pressure medications before your rituximab infusions.
Other medications given during this treatment
- G-CSF: you may be given injection(s) of a drug called G-CSF (also called filgrastim, lenograstim, lipegfilgrastim or pegfilgrastim) under your skin. This helps to boost your white blood cell count. Your white blood cells help to fight infection. Lipegfilgrastim and pegfilgrastim are given once. Filgrastim and lenograstim are given for several days until your white blood cells recover. Your doctor will decide if you need this medication.
- Rituximab premedication: before your treatment with rituximab you will need to take some tablets called a premedication to help prevent you from having a reaction to the rituximab.
- Anti-sickness (anti-nausea) medication: you may be given some anti-sickness medication. Make sure you take this medication as your doctor or nurse tells you, even if you don’t feel sick. This can help to prevent the sickness starting.
- Prophylaxis medication: you may need to take some medications to prevent infection and to help prevent or reduce some of the side effects of the chemotherapy. Your doctor or nurse will tell you how and when to take these medications.