Thioplex

Drug type: Thiotepa is a chemotherapy drug used to treat breast cancer, ovarian cancer, bladder cancer, Hodgkin's lymphoma and, rarely, high grade non Hodgkin's lymphoma. It is one of a group of drugs called alkylating agents. These work by sticking to one of the cancer cell's DNA strands. The cell cannot then divide into 2 new cells.

How you have treatment

Thiotepa is a clear liquid that you can have in a number of different ways

• By injection through a fine tube (cannula) put into a vein (intravenously)
• Through a central line put into a vein near your collarbone
• By injection into a muscle (intramuscular)
• By injection into the fluid around the spinal cord through a lumbar puncture (intrathecally)
• Directly into the bladder (intravesically)

You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for thiotepa depends on which type of cancer you have. There is detailed information about how doctors plan chemotherapy in CancerHelp UK.

Thiotepa side effects are listed below. You can use the links to find out more about each side effect or click on search at the top of the page.

Common side effects

Many people experience a temporary drop in the number of blood cells made by your bone marrow, leading to the following side effects

• Increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should contact your treatment centre straight away if you think you have an infection
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
• Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia). You should contact your treatment centre if you have any of these effects

Other common side effects include

• Fatigue during and after treatment – most people find their energy levels are back to normal within 6 months to a year
• Women may stop having periods (amenorrhoea) but this may only be temporary
• Loss of fertility – you may not be able to get pregnant or father a child after treatment so it is important to talk to your doctor about your fertility before starting treatment if you are concerned
• Thiotepa may harm a developing baby so it is not advisable to become pregnant or father a child if you are having this drug – talk about contraception to your doctor before having the treatment if there is any chance you or your partner could become pregnant

Occasional side effects

Some people may have one or more of the following side effects

• Skin changes such as a rash, itching, darkening or flaking of your skin – these will disappear within a few months of finishing treatment
• Allergic reaction – tell your doctor or nurse straight away if you have a sudden cough or have wheezing, difficulty breathing, itching or a rash
• Feeling or being sick is usually moderate and most likely to start within 12 hours of having treatment – this is usually easily controlled with antisickness injections and tablets, so tell your doctor if you still have sickness as there will be other medicines you can try
• Hair usually thins but complete hair loss is very rare

Rare side effects

A small number of people may have one or more of the following side effects

• Thiotepa directly into the bladder (intravesically) can irritate the lining and make you want to pass urine more often (cystitis) – your doctor can give you medicines to ease this
• There is a small risk that you may get a second cancer some years after thiotepa treatment.
• Thiotepa into spinal fluid (intrathecally) can cause weakness, discomfort and temporary numbness in the legs

Side effects of high dose thiotepa

With high dose thiotepa before a bone marrow or stem cell transplant, you may have

• Drowsiness
• Fits (seizures)
• A sore mouth
• Diarrhoea
• A skin rash

Important points to remember

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Some side effects are inconvenient or upsetting but not damaging to your health.

Some side effects are serious medical conditions and need treating. Where we have urged you to contact your doctor, this is because

• Your side effect may need treating
• Your drug dose may need reducing to try to prevent the side effect

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together. Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse, clinic or ward nurse will give you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Immunisations and chemotherapy

You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.

It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.