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R-CHOP Chemotherapy Protocol

written by: Vikas Vij • edited by: Diana Cooper • updated: 12/25/2010

R-CHOP chemotherapy is the standard treatment protocol for non-Hodgkin lymphoma. The treatment is conducted in six to eight cycles over a period of three to four months.

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    Treatment for Non-Hodgkin Lymphoma

    R-CHOP chemotherapy is an established treatment for non-Hodgkin lymphoma. R-CHOP is an acronym for the combination of drugs used in this treatment. “R" stands for Rituximab which is a monoclonal antibody, “CH" stands for Cyclophosphamide, “O" stands for Oncovin, and “P" stands for a steroid named Prednisolone. Another drug that is a part of the treatment protocol is Doxorubicin. Rituximab is the key part of the therapy, which includes antibodies that work to destroy malignant cells but without harming the healthy cells in any significant way. Rituximab recognizes specific proteins that are found in some cancer cells, and blocks them. This may lead to the activation of the patient’s immune system to fight against the cancer cells, which may result in their destruction. If any healthy WBCs are damaged in the process, they get replaced quickly by the body.

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    How R-CHOP Chemotherapy is Given

    R-CHOP treatment does not require hospitalization and the patient may receive it simply as a day patient. But in some cases, the first treatment may require an overnight stay at the hospital because of the longer duration of the treatment. A blood test is conducted prior to the treatment to ensure that the patient is ready for chemotherapy. Anti-sickness drugs are given along with the drug combination of chemotherapy in order to reduce patient discomfort. The first dosage of Rituximab is infused slowly into the vein over a period of several hours. This is important because some patients may have an allergic reaction to this drug. If allergic symptoms are detected, the physician may slow down the infusion of the drug even further, or stop the treatment till the symptoms reduce.

    Once the patient has adapted to the drug, the remaining treatments can be administered relatively swiftly as a day patient. The R-CHOP therapy includes a combination of injections that are infused into the vein via a drip. The steroid prednisolone is given in tablet form, which is generally before the dosage of Rituximab. The regimen or treatment plan of drugs and the duration of treatment may depend on the condition of the patient. Sometimes the cycle of the treatment may last for three weeks, and in other cases it may be two weeks. Accordingly, the treatment is called R-CHOP21 or R-CHOP14. On average a patient may need to undergo six to eight cycles of treatment spread over a period of three to four months.

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    Possible Side Effects of R-CHOP Treatment

    Some of the common side effects of this chemotherapy treatment include flu-like symptoms in some patients during the course of treatment. Infusion of Rituximab may also lead to low blood pressure. Allergic reactions such as skin rashes, irritation and wheezing are also commonly associated with the treatment. Flushing and redness of face is another possible side effect of this therapy. Patients may also suffer from a reduced resistance to infections, unexplained bleeding, anemia, fatigue, sore mouth and ulcers, hair loss, and a feeling of sickness or nausea.