CVP

CVP is the name of a combination of cancer drugs that includes:

  • C – cyclophosphamide
  • V – vincristine (also known as Oncovin)
  • P – prednisolone, which is a steroid

It is a treatment for low grade non-Hodgkin lymphoma. You usually have CVP with a targeted drug called rituximab. This combination of cancer drugs is called R-CVP.   

How it works

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

How you have CVP

Cyclophosphamide and vincristine are clear fluids. You have them into your bloodstream (intravenously).

You have prednisolone as tablets. You need to swallow them after a meal, or with milk, as they can cause stomach irritation. Your doctor will advise you which dose you need to take. It is best to take prednisolone early in the day, preferably after breakfast.

Into your bloodstream

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

  • central line
  • PICC line
  • portacath

If you don't have a central line

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

Taking your tablets

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

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 CVP

You usually have chemotherapy as cycles of treatment. You may have between 6 and 8 cycles of CVP. Each cycle lasts 3 weeks, so it takes from 4 to 6 months.

You have each cycle of treatment in the following way:

Day 1
  • You have cyclophosphamide as a slow injection into your vein
  • You have vincristine as a drip into your bloodstream over 10 minutes
  • You take prednisolone tablets
Days 2 to 5
  • You take prednisolone tablets
Day 6 to 21
  • You have no treatment

You then start the next cycle of treatment. You can take the prednisolone tablets at home.

Tests

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

How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you're having. For example, your side effects could be worse if you're also having other drugs or radiotherapy.

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

  • you have severe side effects 
  • your side effects aren’t getting any better
  • your side effects are getting worse

Early treatment can help manage side effects better. 

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.

Common side effects

Each of these effects happens in more than 1 in 10 people (more than 10%). You might have one or more of them. They include:

Risk of infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Breathlessness

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Bruising and bleeding

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Tiredness (fatigue)

Tiredness and weakness (fatigue) can happen during and after treatment - doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.

Numbness or tingling in fingers or toes

Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Tell your doctor if you're finding it difficult to walk or complete fiddly tasks such as doing up buttons. 

Pain in your stomach

Vincristine can temporarily stop the normal muscle contractions of the bowel. This causes cramps, sickness and a swollen tummy (abdomen).

Constipation

Constipation is easier to sort out if you treat it early. Drink plenty of fluids and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your doctor or nurse if you are constipated for more than 3 days. They can prescribe a laxative.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.

Loss of appetite

You might lose your appetite for various reasons when you are having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.

Hair loss

You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before. 

Changes in blood sugar levels

You have regular blood and urine tests to check this. If you have diabetes you may need to check your blood sugar levels more often than usual. 

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

  • redness, swelling and pain around the drip site
  • loss of bladder control (incontinence) that is usually temporary
  • taste changes
  • sore mouth
  • pain in your jaw
  • brittle and chipped nails
  • darkening of your skin
  • inflammation of the bladder (cystitis) that can cause pain and blood when passing urine

Rare side effects

Each of these effects happens in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:

  • feeling depressed
  • confusion or hallucinations
  • difficulty sleeping
  • a second cancer some years after treatment
  • swelling in your legs and feet due to a build up of fluid
  • dizziness
  • hearing loss especially with high pitched sounds
  • lung problems such as cough and shortness of breath
  • pain in your bones and muscles
  • blurred or double vision
  • changes to the heart muscle that are usually temporary

Coping with side effects

We have more information about side effects and tips on how to cope with them.

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.

Loss of 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 might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.    

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.

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, pharmacists 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 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)

Contact with others who have had immunisations - You can 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 the oral typhoid vaccine.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

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: 
03 Oct 2018
  • Electronic Medicines Compendium 
    Accessed August 2018

  • Immunisation against infectious disease: Chapter 6: General contraindications to vaccination
    Public Health England
    First published: March 2013 and regularly updated on the Gov.UK website

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

  • CVP chemotherapy plus rituximab compared with CVP as first-line treatment for advanced follicular lymphoma
    R Marcus and others
    Blood, 2005. Vol. 105, Issue 4, Pages 1417-1423

  • CVP Regimen
    Derby-Burton Local Cancer Network, accessed 2018

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