ABVD

Say it: A-B-V-D

Doxorubicin, bleomycin, vinblastine and dacarbazine

ABVD is a standard clinic treatment for Hodgkin lymphoma that combines 4 chemotherapy medicines and is often curative.

Also called: A-B-V-D, AVD, ABVD then AVD, PET adapted ABVD, Adriamycin bleomycin vinblastine dacarbazine

What it is

The 4 medicines attack lymphoma cells in different ways, so together they work much better than any one alone. The goal is cure, and most people with Hodgkin lymphoma are cured. For early stage disease, ABVD may be paired with radiation. A PET scan after 2 cycles often guides the rest of treatment.

Often used for

• Classic Hodgkin lymphoma, early stage
• Classic Hodgkin lymphoma, advanced stage

ABVD then AVD (PET adapted)

If the PET scan after 2 cycles looks good, bleomycin is often dropped for the rest of treatment. This lowers the risk of lung damage without lowering the cure rate.

ABVD with radiation

For early stage Hodgkin lymphoma, 2 to 4 cycles of ABVD may be followed by radiation to the involved area.

The medicines in this plan

Doxorubicin (Adriamycin)

An anthracycline chemotherapy (a red medicine). Given through a vein on days 1 and 15.

Bleomycin

An antibiotic type of chemotherapy. Given through a vein on days 1 and 15. It can affect the lungs, so breathing is watched closely.

Vinblastine

A plant based chemotherapy that stops cells from dividing. Given through a vein on days 1 and 15.

Dacarbazine

Chemotherapy given through a vein over about 1 hour on days 1 and 15. It can sting the vein and cause nausea.

How you get it

ABVD is given in an outpatient infusion clinic. A treatment day takes about 3 to 5 hours. You get treatment on days 1 and 15 of a 28 day cycle. Early stage disease usually needs 2 to 4 cycles, and advanced disease usually needs 6 cycles. Many people get a port. Your schedule may be different.

A typical cycle

Day 1

Blood tests, then nausea medicines, then IV doxorubicin, bleomycin, vinblastine and dacarbazine.

Days 2 to 5

Nausea, tiredness and a metal taste are most common now.

Days 7 to 12

White blood cells are lowest. Watch for fever.

Day 15

Blood tests, then the same 4 medicines again.

Days 16 to 28

Rest and recovery. A PET scan is usually done after cycle 2.

Common side effects and what helps

• Nausea and vomiting, mostly in the first 1 to 2 days. Take nausea medicines on schedule.
• Feeling very tired. Balance rest with light activity.
• Hair thinning or loss. It grows back after treatment ends.
• Low white blood cells and a higher risk of infection. Wash hands often.
• Constipation from vinblastine. Drink fluids and use stool softeners if advised.
• Fever or chills on the day of bleomycin. Your team may give medicine to prevent this.
• Darkening of the skin or streaks on the skin from bleomycin. Avoid scratching and protect skin from the sun.
• Pain or burning in the vein during dacarbazine. Tell your nurse right away.
• Tingling in the fingers or toes. Report it at each visit.

Call your care team right away if you have

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• A new dry cough, shortness of breath, or trouble breathing when you walk
• Chest pain or a racing heartbeat
• Pain, redness or swelling where the IV went in
• Constipation for 3 days or more with belly pain
• Vomiting that keeps you from drinking fluids for a day
• Bleeding or many new bruises

Good to know

• A breathing test (pulmonary function test) is done before starting and sometimes during treatment because bleomycin can harm the lungs.
• A heart test (echocardiogram or MUGA scan) is done before starting because doxorubicin can weaken the heart.
• Do not smoke. Tell any future surgeon or anesthesia team that you had bleomycin, since high oxygen levels can harm your lungs.
• Treatment is usually given on time even if white blood cells are low, as long as you have no fever.
• Avoid pregnancy during treatment. Ask about fertility protection before starting.

At home

• Take nausea medicines on schedule for the first 2 to 3 days.
• Check your temperature if you feel unwell, and call for a fever.
• Drink plenty of fluids and keep bowels moving.
• Protect your skin from the sun with clothing and sunscreen.
• Avoid smoking and vaping, and stay away from secondhand smoke.

Questions to ask

• How many cycles will I need?
• Will bleomycin be stopped after my PET scan?
• Will I need radiation too?
• How will you check my lungs and heart?
• How can I protect my fertility?
• What are the chances this will cure my lymphoma?

Lymphoma

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.