Hematologist
CION Cancer Clinics
What to expect from ABVD chemotherapy | CION Cancer Clinics
ABVD is four chemotherapy drugs, doxorubicin, bleomycin, vinblastine and dacarbazine, given into a vein every two weeks as a day-care visit. Two treatments make one four-week cycle, and most people have between two and six cycles. Expect tiredness, hair loss and a higher infection risk. A fever during treatment needs emergency care the same day. Here is what each stage involves. At CION Cancer Clinics, our haematology team plans myeloma and lymphoma care with you, discussed at a tumour board and explained in plain words.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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The short answer
What happens during ABVD chemotherapy?
ABVD is a combination of four chemotherapy drugs given into a vein every two weeks, usually as a day-care visit. Two treatments make one cycle of four weeks. Most people with Hodgkin lymphoma have between two and six cycles, depending on the stage and the scans during treatment.
The four drugs
The letters stand for doxorubicin (once called Adriamycin), bleomycin, vinblastine and dacarbazine. Each attacks lymphoma cells in a different way, and together they work better than any one alone. ABVD has been a standard first treatment for classical Hodgkin lymphoma for many years.
How it fits into your life
You come in, have blood tests, see the doctor, and then have the drugs through a drip over a few hours. You usually go home the same day. Many people keep up light work or study between treatments, though tiredness tends to build as the cycles go on. Your haematologist sets the schedule, the doses and any changes. Never change or skip a treatment on your own.
Some plans use a version without bleomycin, called AVD, or add a newer drug. Your team will tell you which one you are on.On the day
What does a treatment day look like?
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Blood tests on arrival
A blood count checks your white cells, which fight infection, and your platelets, which help blood clot. The team decides whether it is safe to go ahead that day.
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A short review
Tell the doctor or nurse about fevers, cough, breathlessness, numbness, constipation or anything new since the last visit.
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Medicines to prevent sickness
Anti-sickness medicines are given before the chemotherapy, and more are usually prescribed to take at home.
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The infusion
A cannula, a thin tube, is placed in a vein, or a longer-term line is used. The drugs are given one after another over a few hours. Tell the nurse at once if the drip site stings or swells.
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Going home
You leave with a written list of medicines, a date for the next visit and a number to call if you feel unwell.
Not sure whether this applies to you?
Ask an oncologistSide effects
Which side effects are common with ABVD?
Not everyone has all of these. Most ease after treatment ends. Tell your team early, because most are easier to manage when caught soon.
Feeling sick and tiredness
Sickness is usually worst in the first day or two after a treatment and is well controlled with medicines. Tiredness often builds over the course.
Infection risk
Your white cell count dips between treatments, so infections can become serious quickly. Wash hands often and avoid people who are clearly unwell.
Hair thinning or loss
Many people lose some or all of their hair. It usually starts growing back within a few months of finishing.
Numbness and constipation
Vinblastine can cause tingling in the fingers and toes, and constipation. Report both, as the team may adjust treatment.
Red urine and vein soreness
Doxorubicin turns urine pink or red for a day or so. That is expected. Dacarbazine can make the vein ache during the drip.
Also tell the team about
- Mouth sores
- Skin darkening or rashes
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Fever during ABVD cannot wait
If your temperature reaches 38 degrees Celsius or more, or you are shivering, feel suddenly very unwell, or become breathless, go to the nearest emergency department straight away or call 108. Say you are on chemotherapy for lymphoma. Do not wait for the morning, and do not take fever medicine first to see if it settles.
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Longer-term effects
What should I know about the lungs, heart and fertility?
Two ABVD drugs can affect major organs, so your team checks them before and during treatment. Knowing the warning signs helps you speak up early.
Bleomycin and the lungs
Bleomycin can inflame the lungs. Report a new dry cough or breathlessness straight away. Tell the team if you smoke, and tell any anaesthetist for years afterwards that you had bleomycin, as oxygen during surgery needs care. If lung problems appear, the team may stop bleomycin and continue without it.
Doxorubicin and the heart
Doxorubicin can weaken the heart muscle in some people. A heart scan or echocardiogram is often done before starting. Report chest pain, a racing heartbeat or swelling of the ankles.
Who ABVD may not suit
People with serious heart or lung disease, and some older adults, may be offered a changed plan. ABVD usually has a smaller effect on fertility than stronger regimens, but discuss sperm banking or egg freezing before the first treatment.
Commonly believed
What do families often get wrong about ABVD?
"Chemotherapy will make the patient bedridden for months."
ABVD is usually given as day care, and many people stay on their feet, eat at home and keep light routines. Tiredness is real, so plan rest, but most people are not confined to bed.
"If a treatment is postponed, it will stop working."
Sometimes a treatment is delayed because counts are low or you have an infection. The team makes that call to keep you safe. Do not delay or skip on your own, but a short planned delay is not a failure.
"Herbal remedies will protect the body from the chemotherapy."
Some herbs and supplements affect the liver or interact with chemotherapy drugs. Show every remedy, powder or tonic to your team before taking it.
"The patient must not be near children during treatment."
Family life can continue. Keep away from anyone with an infection, and ask the team about precautions with body fluids in the day or two after each treatment.
Being straight with you
What can this page not tell you?
This page cannot tell you how many cycles you will have, how you will respond or which side effects you will get. Those depend on your stage, your health, your blood counts and your PET-CT scans during treatment. The name of a regimen carries no prognosis on its own.
Paying for treatment
ABVD is often covered under Aarogyasri, PM-JAY, CGHS, ECHS, EHS or cashless insurance, depending on your eligibility. Scheme rules change, so check the current rules for your card or policy. At CION the haematology team reviews your case, presents it at a tumour board, and helps you understand what your scheme covers.
How the family can help
Keep a small notebook for each cycle: the date, the temperature if you feel hot, any side effects and questions for the next visit. Keep a working thermometer at home. Save the emergency number and the team's number on every family phone. Plan transport home after each treatment, because tiredness and sickness can make travel hard.
Questions we are asked
Common questions about ABVD chemotherapy
How long does a full course of ABVD take?
Each cycle lasts four weeks, with a treatment every two weeks. Most people have between two and six cycles, so the course runs from about two months to about six months. Delays for low counts or infections can add time. Your haematologist tells you the plan and when it may change.
Can I work or go to college during ABVD?
Many people do, with adjustments. Desk work or classes are often manageable, especially in the second week after a treatment. Avoid crowded places when counts are low, and plan rest. Jobs with heavy physical effort or infection risk may need a break. Talk it through with the team.
What should I eat during treatment?
Eat small, frequent meals of freshly cooked food, and drink plenty of clean water. Avoid raw or undercooked eggs and meat, and street food, while counts are low. Protein from dal, eggs, paneer, curd and fish helps. If eating is hard, ask for a dietitian.
Why was my treatment postponed because of a blood test?
ABVD lowers the white cell count, and sometimes the team waits for it to recover, or supports it with an injection, before the next treatment. Reference ranges differ between laboratories, and one result is read with how you feel. The team decides whether to go ahead.
Will my hair grow back?
In almost everyone, yes. Hair usually starts to return within a few months of the last treatment. It may be a slightly different texture or colour at first. Scarves, caps and short haircuts before hair loss begins can make the change easier to manage.
Can I get vaccines during ABVD?
Some vaccines are safe and recommended, such as the flu vaccine, but live vaccines should be avoided. Timing matters. Ask your haematologist before any vaccine, and tell family members who plan vaccinations for children so the team can advise.
What happens after the last cycle?
A PET-CT scan is usually done some weeks after treatment ends to check the response. Some people then have radiotherapy. After that come regular follow-up visits, with checks on blood counts, thyroid, heart and lungs, and advice on long-term health.
Is ABVD given at CION?
CION's haematology team evaluates each case, presents it at a tumour board and plans treatment with you. Where any part of care is not provided in-house, the team coordinates it with a qualified centre. Ask the team where each part of your treatment will take place.
Your Haematologist
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Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- Cancer Research UK — ABVD
- American Cancer Society — Chemotherapy for Hodgkin Lymphoma
- Macmillan Cancer Support — ABVD
- National Cancer Institute — Hodgkin Lymphoma Treatment (PDQ) - Patient Version
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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