R-CHOP stands for of the following drugs used in combinations to treat mainly non-Hodgkin’s lymphoma-

• Rituximab - is a monoclonal antibody
• Cyclophosphamide - an alkylating agent which damages DNA by binding to it and causing cross-links
• Hydroxydaunorubicin - an intercalating agent which damages DNA by inserting itself between DNA bases
• Vincristine (Oncovin) - which prevents cells from duplicating by binding to the protein tubulin
• Prednisolone - a corticosteroid

On the first day of the R-CHOP chemotherapy  treatment, rituximab, doxorubicin, vincristine and cyclophosphamide would be administered and a five-day course of prednisolone tablets would be started. After the tablets are over there is a rest period for 16 days. This is one cycle. Each cycle takes 21 days. and 6-8 cycles are done in a period of 3-4 months.

Side Effects of R-CHOP Chemotherapy

Although R-CHOP chemotherapy is used in the treatment of non-Hodgkin’s lymphoma, the regimen also causes certain side effects. Given below are some of the common side effects of R-CHOP chemotherapy regimen.

Flu-like symptoms - Rituximab causes fever, chills, weakness, muscle pains, dizziness and headaches.

Low blood pressure - Patients suffering from low blood pressure are recommended to take their tablets 12 hours before administering rituximab as it causes changes in the blood pressure.

Allergic reactions - Rituximab causes allergic reactions like skin rashes, itching, swelling in the throat, irritation of the nasal passage a feeling of swelling in the tongue or throat, irritation of the nasal passages, wheezing, cough and breathlessness. The doctor could recommend antihistamines.

Flushing - Sudden warmth and reddening of the face happens due to rituximab.

Lowered resistance to infection (neutropenia) - This happens due to lowered number of white blood cells.

Bruising or bleeding - This is due to lowered count of platelets that could cause nosebleeds, bleeding gums, blood spots or rashes on the skin.

Anemia - This causes fatigue and breathlessness due to low count of the red cells.

Nausea and vomiting - This is a common side effect and the doctor could recommend anti sickness medications to reduce this.

Constipation - Vincristine and some anti-sickness drugs cause constipation, which could be controlled by some home remedies or laxatives.

Fatigue - This is bound to happen as the treatment itself is very exhaustive.

Hair loss - This starts within 3-4 weeks after the first cycle. It could be hair thinning or total baldness along with loss of eyebrows, eyelashes, body hair and pubic hair.

Mouth ulcers - This treatment causes dry mouth and small ulcers. Good oral hygiene and taking plenty of fluids is essential. Medication could be recommended if required.

Taste changes - You could develop a metallic or bitter taste in the mouth.

Irritation of the stomach lining - Prednisolone damages the stomach’s protective layer, exposing it to the stomach acid. This causes indigestion and acidity.

Irritation of the bladder - Cyclophosphamide causes bladder irritation and difficulty in passing urine. It is essential to drink plenty of water.

Numbness or tingling in hands or feet - This is due to vincristine that damages the nerves causing peripheral neuropathy.

Changes in blood sugar level - Prednisolone make the blood sugar level to rise. The doctor could recommend regular monitoring of the blood sugar.

Fluid retention - Prednisolone could affect the salt-water balance in the body, which could develop swelling in the ankles or hands.

Nail changes - The nails look dark and brittle with white lines.

Behavioral changes - Prednisolone causes mood swings and intense emotions of worry and anxiety.

Fertility - These drugs cause early menopause in women. They affect the ovulation process. The quality and viability of sperms could be affected in men. A woman should not conceive while undergoing chemotherapy as it damages the fetus.

R Chop chemotherapy is a standard therapy for most types of non-Hodgkin’s lymphomas like diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, mantle cell lymphoma, primary mediastinal B-cell lymphoma, extranodal natural killer/T-cell lymphoma and anaplastic large cell lymphoma. There are clinical trials going on wherein some new drugs like epratuzumab are being tried.