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Find out what ChlVPP is, how you have it and other important information about having ChlVPP.

ChIVPP is the name of a combination of cancer drugs which includes:

  • Chl – chlorambucil
  • V – vinblastine
  • P – procarbazine
  • P – prednisolone, which is a steroid

It is a treatment for Hodgkin lymphoma.  

How it works

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

How you have it

You have ChlVPP into your bloodstream (intravenously) and as tablets and capsules that you swallow. You have:

  • chlorambucil as tablets that you swallow whole with plenty of water 30 to 60 minutes before you eat any food (keep tablets in the fridge)
  • vinblastine as an injection into your bloodstream (intravenously)
  • procarbazine as capsules that you swallow whole with plenty of water
  • prednisolone as tablets that you swallow whole with plenty of water after breakfast

Drugs into your bloodstream

You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Taking your capsules and tablets

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

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

You should take the right dose, not more or less.

Talk to your specialist or advice line before you stop taking a cancer drug.

When you have it

You have ChlVPP chemotherapy as cycles of treatment. Each cycle of treatment lasts 4 weeks (28 days). You might have between 4 and 6 cycles, taking 4 to 6 months in total. 

Day 1
  • You have vinblastine as an injection into your bloodstream (intravenously) via a fast running drip
  • You take chlorambucil tablets
  • You take procarbazine capsules
  • You take prednisolone tablets in the morning
Day 2 to day 7
  • You take chlorambucil tablets
  • You take procarbazine capsules
  • You take prednisolone tablets in the morning
Day 8
  • You have vinblastine as an injection into your bloodstream (intravenously) via a fast running drip
  • You take chlorambucil tablets
  • You take procarbazine capsules
  • You take prednisolone tablets in the morning
Day 9 to day 14
  • You take chlorambucil tablets
  • You take procarbazine capsules
  • You take prednisolone tablets in the morning
Day 15 to day 28
  • you have no treatment

You then start a new cycle of treatment. 


You have blood tests before 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

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.

Food and alcohol

Procarbazine interacts with alcohol and some foods, causing sickness, headaches, difficulty breathing, sweating, faintness or drowsiness. You should not drink alcohol while you are taking procarbazine.

Reactions to food are rare, so if you want to try a food on this list, you could have a little at a time until you are sure it won't upset you:

  • mature cheeses (including processed cheeses)
  • yeast or meat extracts such as Marmite, Oxo, and Bovril
  • salami and pepperoni
  • overripe fruit, broad beans
  • foods which have been fermented, pickled, smoked, hung or matured

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're having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.


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.


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, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.


Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

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

You can:

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

Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as oral polio or the typhoid vaccine.

This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened. 

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.

Last reviewed: 
26 Feb 2018
  • Electronic Medicines Compendium 
    Accessed February 2018

  • Handbook of Cancer Chemotherapy (8th edition)
    Roland K Keel
    Lippincott, Williams and Wilkins, 2012

  • ChlVPP

    South East London NHS Cancer Network, 2008

  • ChLVPP

    St Lukes Cancer Alliance, 2016

  • ChlVPP/ABVVP, a first line ‘hybrid’ combination chemotherapy for advanced Hodgkin's lymphoma: a retrospective analysis
    G Martinelli and others
    British Journal of Haematology, 2004. Vol 125, issue 5, pages 584-589

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