R-CHOP

R-CHOP

R-CHOP is a combination chemotherapy regimen used primarily in the treatment of non-Hodgkin lymphoma (NHL), particularly diffuse large B-cell lymphoma (DLBCL). It is an acronym for the five drugs that make up the regimen: Rituximab, Cyclophosphamide, Hydroxydaunorubicin (also known as Doxorubicin), Oncovin (Vincristine), and Prednisone.

Components of R-CHOP

Rituximab

Rituximab is a monoclonal antibody that targets the CD20 antigen on the surface of B-cells. It is used to destroy both normal and malignant B-cells, making it effective in treating B-cell lymphomas. Rituximab is administered intravenously and is known to enhance the effects of chemotherapy.

Cyclophosphamide

Cyclophosphamide is an alkylating agent that works by cross-linking DNA strands, thereby preventing cell division and leading to cell death. It is a prodrug that is activated in the liver and is administered intravenously.

Hydroxydaunorubicin (Doxorubicin)

Doxorubicin is an anthracycline antibiotic that intercalates DNA, disrupting the replication of cancer cells. It also generates free radicals that damage cellular components. Doxorubicin is given intravenously and is known for its cardiotoxicity, which limits its cumulative dose.

Oncovin (Vincristine)

Vincristine is a vinca alkaloid that inhibits microtubule formation in the mitotic spindle, arresting cell division at metaphase. It is administered intravenously and is associated with neurotoxicity, particularly peripheral neuropathy.

Prednisone

Prednisone is a corticosteroid that induces apoptosis in certain cancer cells and reduces inflammation. It is taken orally and helps mitigate some of the side effects of chemotherapy, such as nausea and allergic reactions.

Administration and Dosage

R-CHOP is typically administered in cycles, with each cycle lasting 21 days. The number of cycles depends on the stage and type of lymphoma being treated. The regimen is usually given in an outpatient setting, with close monitoring for side effects and response to treatment.

Side Effects

Common side effects of R-CHOP include:

• Myelosuppression, leading to increased risk of infection
• Nausea and vomiting
• Hair loss (alopecia)
• Fatigue
• Neuropathy (due to Vincristine)
• Cardiotoxicity (due to Doxorubicin)

Patients are monitored for these side effects, and supportive care is provided to manage them.

Efficacy

R-CHOP is considered the standard of care for DLBCL and has significantly improved survival rates. The addition of Rituximab to the CHOP regimen has been shown to increase overall survival and progression-free survival in patients with B-cell lymphomas.

Also see

• Non-Hodgkin Lymphoma
• Diffuse Large B-Cell Lymphoma
• Chemotherapy
• Monoclonal Antibody Therapy