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R-CHOP

Find out about the chemotherapy drug combination R-CHOP, and other important information about having R- CHOP.

R-CHOP in a cancer drug combination. It includes:

  • R - rituximab (Mabthera)
  • C – cyclophosphamide
  • H – doxorubicin hydrochloride
  • O – vincristine (which used to be called Oncovin)
  • P – prednisolone (a steroid)

It is a treatment for non Hodgkin lymphoma.

How R-CHOP works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

Rituximab is a type of targeted cancer drug called a monoclonal antibody. Monoclonal antibodies target proteins on the surface of cells. Rituximab targets a protein known as CD20. CD20 is found on white blood cells called B cells. It is the B cells that are cancerous in the most common type of non Hodgkin lymphoma.

Rituximab attaches itself to the B cells and marks them. The cells of the immune system recognise the marked cells and kill them.

How you have R-CHOP

You have the drugs into your bloodstream (intravenously). Prednisolone is a steroid, you take this as a tablet.

Into your bloodstream

You can have the drug through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

Or you might have it through a long line: a central line, a PICC line or a portacath.

These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment.

Taking your tablets

You must take tablets according to the instructions your doctor or pharmacist gives you.

Speak to your pharmacist if you have problems swallowing the tablets.

Whether you have a full or an empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose; no more, no less.

Never stop taking a cancer drug without talking to your specialist first.

When you have it

You usually have R-CHOP in cycles of treatment over 3 weeks. A usual course of treatment consists of between 3 and 8 cycles so it can last from 9 to 24 weeks.

Some people may have R-CHOP over 2 weeks. You have the drugs in exactly the same way, but with less of a break between treatments. Doctors call treatment over 2 weeks R-CHOP14. Treatment over 3 weeks is called R-CHOP21.

On the first day of each cycle you have the following drugs:

  • rituximab
  • cyclophosphamide
  • vincristine
  • doxorubicin

You have prednisolone (steroid) tablets to take at home for 5 days. Then you have a break with no treatment until the next treatment cycle starts.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Fertility

You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Breastfeeding

Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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