CHOP is a standard chemotherapy regimen used primarily for non-Hodgkin lymphomas, particularly diffuse large B-cell lymphoma (DLBCL).
CHOP Components:
| Drug | Generic Name | Mechanism/Role |
|---|---|---|
| C | Cyclophosphamide | Alkylating agent; cross-links DNA |
| H | Hydroxydaunorubicin (Doxorubicin) | Anthracycline; intercalates DNA, inhibits topoisomerase II |
| O | Oncovin (Vincristine) | Vinca alkaloid; inhibits microtubule formation |
| P | Prednisone | Corticosteroid; lympholytic and anti-inflammatory |
Dosing (Typical 21-day cycle):
- Cyclophosphamide: 750 mg/m² IV Day 1
- Doxorubicin: 50 mg/m² IV Day 1
- Vincristine: 1.4 mg/m² IV (max 2 mg) Day 1
- Prednisone: 100 mg orally Days 1–5
Indications:
- Diffuse large B-cell lymphoma (DLBCL)
- Peripheral T-cell lymphoma (sometimes)
- Follicular lymphoma (grade 3 or aggressive disease)
Common Toxicities:
- Myelosuppression (esp. neutropenia)
- Cardiotoxicity (from doxorubicin)
- Neurotoxicity (vincristine: peripheral neuropathy)
- Immunosuppression and infections
- GI side effects (nausea, mucositis)
- Steroid-related effects (hyperglycemia, mood changes)
Pharmacist Monitoring:
- CBC with differential (neutropenia, thrombocytopenia)
- LFTs and renal function
- Cardiac function (baseline LVEF if using anthracyclines)
- Signs of infection or sepsis
- Peripheral neuropathy symptoms
- Ensure correct dose caps (e.g., vincristine max 2 mg)
Variants: