Thiotepa

What is thiotepa?

Thiotepa is a medicine used to treat various types of cancers. It may also be given as part of the preparation for bone marrow or stem cell transplant. It is usually given together with other medicines.

Thiotepa is given through a vein (intravenously).

Before giving thiotepa to your child

Tell your child’s health-care provider if your child:

• has ever reacted badly to thiotepa or to any other medications, foods, preservatives or colouring agents
• is taking phenytoin because it may interact with thiotepa

Talk with the health-care provider or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• an infection or recent exposure to infection (such as chickenpox)
• kidney or liver problems

How will your child get thiotepa?

Thiotepa is a clear liquid that a nurse will give by needle into your child’s vein (intravenously, or IV). Your child will get this medicine in the hospital clinic or on a nursing unit.

What are the possible side effects of thiotepa?

Your child may have some of these side effects while they take thiotepa. Check with your child's health-care provider if your child continues to have any of these side effects or they bother your child:

• dizziness or drowsiness
• not feeling hungry or loss of appetite
• nausea (feeling like throwing up) or vomiting (throwing up)

Your child will receive medicine to prevent nausea, upset stomach and vomiting caused by thiotepa.

Your child may lose their hair. It will grow back once your child is no longer receiving thiotepa. Its colour and texture may change. Use a gentle shampoo and a soft brush on your child’s hair.

Call your child's health-care provider during office hours if your child has any of these side effects:

• pain in joints
• pain at place of injection
• swelling of feet or lower legs
  

Thiotepa may cause sores in the mouth. Brush your child’s teeth gently after eating and at bedtime. Your child’s health-care provider or dentist may suggest different ways to clean your child’s mouth and teeth. If brushing becomes difficult, rinse your child’s mouth with a mouthwash made from baking soda to help keep it clean. Your child’s nurse or pharmacist can review this with you. Avoid store-bought mouthwash containing alcohol as it may sting and cause dry mouth.

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child’s health-care provider right away or take your child to the Emergency Department if your child has any of these side effects:

• rash or skin discolouration/darkening
• fever or chills
• cough or sore throat
• blood in the urine or stools
• black, tarry stools
• pinpoint red spots on skin
• painful or difficult urination
• lower back or side pain
• tightness in the throat
• wheezing or trouble breathing
• hives (raised, red itchy areas on the skin)
• seizures (convulsions)
• eye irritation or changes to eyesight

What safety measures should you take when your child is using thiotepa?

Check with your child’s health-care provider or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal or natural products).

After treatment with thiotepa, this medicine will come through the skin in the perspiration (sweat). This can cause irritation of the skin and can cause the skin to change colour. As a result, your child will need specific skin care while receiving thiotepa and for several hours afterward. You or your child’s caregivers may be exposed to small amounts of thiotepa if they are in contact with your child’s skin, vomit, urine, stools and blood. Use safe handling precautions when dealing with body fluids.

Thiotepa can lower the number of white blood cells in the blood temporarily, which increases your child’s chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the blood count is low:

• Avoid people with infections, such as a cold or the flu.
• Avoid places that are very crowded with large groups of people.
• You and your child should not touch your child’s eyes or inside their nose without washing hands first.
• Your child’s nurse will review with you what to do in case of fever.

Thiotepa can lower the number of platelets in the blood, which increases your child’s risk of bleeding. You can take the following precautions:

• Be careful not to cut your child when using a razor, fingernail scissors or toenail clippers.
• Your child should avoid contact sports where bruising or injury could occur.
• Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking thiotepa.
• Your child should not receive a permanent tattoo or any kind of body piercing.

Your child should not receive any immunizations (vaccines) without your child’s health-care provider’s approval. Your child or anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child’s health-care provider if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine.

There is a chance that thiotepa may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy. If your child is sexually active, it is best that they use some kind of birth control while receiving thiotepa. Tell the health-care provider right away if your child may be pregnant.

After receiving thiotepa, your child may not be able to have children later in life or may have difficulty having children. Your child’s health-care provider will discuss this in more detail with you or your child.

What other important information should you know about thiotepa?

Keep a list of all medications your child is on and show the list to the health-care provider or pharmacist.

At SickKids

You will be given an information sheet called “Caring for Your Child’s Skin during Thiotepa Therapy”. Consult this sheet for more information about how to care for your child’s skin and avoid exposure of thiotepa for caregivers.

Keep medications out of your child's sight and reach and locked up in a safe place. If your child takes too much of a medication, call the Ontario Poison Centre at one of these numbers. These calls are free.

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.