CHOP Chemotherapy for Lymphoma

Treatment for Non-Hodgkin Lymphoma

Chemotherapy drugs.
Chemotherapy drugs.. Chris Hondros/Getty Images

What is CHOP Chemotherapy?

CHOP is an abbreviated name for a combination of drugs used in chemotherapy for some common types of aggressive Non-Hodgkin Lymphoma (NHL). It consists of four drugs - Cyclophosphamide (also called Cytoxan/Neosar), Doxorubicin (or Adriamycin), Vincristine (Oncovin) and Prednisone. Its is also often combined with Rituximab in the R-CHOP regimen.

The first three drugs of the CHOP chemotherapy regimen are usually given as injections or infusions in veins on a single day, while prednisone is taken as pills for five days.

Each cycle is repeated every three weeks for 6-8 cycles.

The drugs given in CHOP attack the ability of actively dividing cells to replicate. They damage DNA and prevent cells from duplicating. Cancer cells are more vulnerable than normal cells, but the chemotherapy also has effects on normal cells, resulting in hair loss and nausea during treatment and you may experience infertility or permanent sterility.

Lymphomas Treated with CHOP

CHOP chemotherapy is used for many of the common types of aggressive non-Hodgkin lymphomas including diffuse large B-cell lymphoma (DLBCL), angioimmunoblastic T-cell Lymphoma, and peripheral T-cell lymphoma, The R-CHOP protocol has become standard for treatment of aggressive, Stage I and contiguous Stage II Adult NHL and aggressive, noncontiguous Stage II/III/IV adult NHL.

CHOP Administration and Cautions

Adriamycin is usually given first as it can irritate your blood vessels.

It's important that you tell the infusion nurse if you feel burning or pain at the infusion site. On the same day, you will also be given the next two drugs, Cytoxan and Vincristine.

The clinic will probably recommend that you have a driver to take you home after each treatment. You may see a change in the color of your urine from the red color of the Adriamycin for a couple of days after treatment.

Common Side Effects of CHOP Therapy

  • Hair loss: You will have total hair loss, including the hair on your head as well as eyebrows, eyelashes, and body hair. Usually this starts two to three weeks after treatment, but it is temporary and your hair should return after treatment.
  • Nausea and vomiting are common, from immediately after treatment through three days after treatment.
  • Constipation is common due to the Vincristine as well as other medications often given for nausea and pain.
  • Mouth sores may appear a week to two weeks after treatment.
  • Fertility issues: Women often have a disruption of their menstrual cycles and may enter menopause permanently. Men may stop producing sperm, reducing fertility. These conditions may be permanent, so you should discuss fertility options with your doctor before starting treatment. On the other hand, don't assume you will be infertile during treatment, use contraception to prevent pregnancy.
  • You may be more prone to infection during CHOP treatment as it will temporarily reduce your white blood cells and red cells, impairing your immune system. It is wise to avoid contact with people who colds or the flu and to wash your hands frequently to prevent catching a virus or infection.
  • Prednisone is a steroid and has many potential side effects, including mood swings, weight gain and swelling.

Sources:

Possible Side Effects of Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) , National Cancer Institute, November 27, 2013.

Adult Non-Hodgkin Lymphoma Treatment–for health professionals (PDQ®), National Cancer Institute, January 15, 2016.

Continue Reading