CHOP and breastfeeding

[Ewgh]

Hello- I am scheduled for my last round of CHOP tomorrow for NHL. I have a 5 week old baby and am my question is regarding the vincristine. Initially I was told by my oncologist and OB that it was safe to resume breastfeeding after 10-14 days. However, now they are both telling me "they can't be sure". Three questions:

1. Do I need to wait 35 days for the vincristine on the off chance that it is actually excreted in the breast milk or is there any literature suggesting otherwise?
2. I breastfed my daughter at birth for 10 days (until my next round of chemo). She was born 17 days after the last chemo. If I was not making milk when I had the vincristine, is there any chance it could be excreted in the milk later (assuming it was still in my system)?
3. Does anyone test blood or breastmilk for vincristine?

Thanks,

EMILY

[Sandra]

Ewgh,

I spoke with Dr Hale about this he recommended the following:


1. Vincristine is rated an L5-no data-hazardous. [COLOR=#333333][FONT=lucida grande]No data are available on its transfer into human milk, but its levels are probably low due to a relatively higher molecular weight of 923 daltons. However, mothers should be advised to withhold breastfeeding for a minimum of 35 days following treatment, as this product is slowly eliminated from the body.

2. The terminal half-life of vincristine is anywhere from 19-155 hours, so for 5 half-lives and 98% to be out would be anywhere from 4-32 days, we would not know where you would fall in this range of time. Potentially it could have been in the breast milk at 17 days, but Dr Hale thinks it is low risk. It has a large molecular weight, so would have a hard time entering the breast milk, but this is a nasty drug, so for future use we still recommend the 35 days.

3. You may be able to find a lab that could check your plasma levels, but probably not your milk. We do not know of any so you would just need to check around.

I hope this helps.

Sandra Lovato R.N.
InfantRisk Center
806352-2519[/FONT][/COLOR]