• Hair loss from Treanda is rare.
• If it does occur, it is usually very mild and not noticeable from a distance.
• Usually, a different hairstyle will help disguise any loss. A wig or hairpiece is usually not needed.

Treanda (bendamustine HCl) may be used to treat chronic lymphocytic leukemia (CLL) or indolent (slow-growing) B-cell non-Hodgkin lymphoma that has progressed despite treatment.

Hair loss as a side effect of Treanda treatment is very rare.

Data indicates hair loss occurred in 1 out of 153 people treated with bendamustine for CLL, and 3 out of 100 people treated with bendamustine for NHL. If hair loss does occur, it is almost always mild and only seen on close inspection not obvious from a distance. Often a different hairstyle can help cover hair loss, a wig or hairpiece is not usually needed.

How to reduce hair thinning from cancer treatments

Treating your hair gently may help minimize hair thinning. Some tips include:

• Use a low-sulfate, gentle shampoo or conditioner
• Wash your hair with lukewarm water only
• Minimize brushing of hair close to the scalp, try to gently brush the ends only
• Use a wet brush to gently brush your hair before you wash it
• Avoid cutting the hair too short as long hair helps to cover small patches of hair loss
• Avoid hair ties and fasteners, use pins or crocodile clips instead
• Protect your scalp from the sun
• Avoid perming or straightening your hair, only use heated rollers or curling wands occasionally If you color your hair use a vegetable-based organic hair color which is more gentle on your hair and scalp
• Dry your hair naturally or use the cool setting on a hairdryer.

How does Treanda work?

Treanda is a nitrogen mustard derivative and is classified as an alkylating agent.

A cell cycle goes through three phases: resting, active growing, and mitosis (division). Alkylating agents work best in the resting phase of the cell cycle, although they may also work in the active phase. Treanda is active against both resting and dividing cells.

Although the exact way Treanda works is not known, the structure of it means that it readily forms bonds with other electron-rich structures, which result in interstrand DNA crosslinks and very strong (covalent) bonds. This bonding can lead to cell death in several different ways.

Because cancer cells divide more rapidly than normal cells, they are more affected by this bonding and the death rate of cancerous cells is greater than the death rate of normal cells. This slows the growth of cancer cells in the body.

What are the side effects of Treanda?

Although Treanda is more effective at killing cancerous cells compared to normal cells, normal cells are still affected, which results in side effects.

Normal cells most affected by chemotherapy with Treanda are blood cells, and cells in the mouth, stomach, and bowel.

The most common side effects of Treanda include:

• Black tarry stools
• Bleeding gums
• Blood in the urine or stools
• Diarrhea
• Constipation
• Cough
• Difficulty breathing
• Headache
• Loss of appetite
• Low red and white blood cells, low platelets
• Mouth ulcers and irritation
• Nausea
• Rash
• Stuffy or runny nose
• Tiredness
• Weight loss.

Other side effects that may occur include:

• Infections or a recurrence of infections
• Kidney or liver damage
• Other cancers
• Leaking of Treanda into the surrounding skin causing burning or stinging
• Swelling of the eyelids, face, lips, hands, or feet.