Used mainly in indolent non-Hodgkin lymphomas (e.g., follicular lymphoma) and sometimes in other B-cell lymphomas.
Components
- R = Rituximab (anti-CD20 monoclonal antibody)
- C = Cyclophosphamide (alkylating agent)
- V = Vincristine (Oncovin®, vinca alkaloid)
- P = Prednisone (corticosteroid)
Typical Dosing (21-day cycle)
- Rituximab: 375 mg/m² IV on Day 1
- Cyclophosphamide: 750 mg/m² IV on Day 1
- Vincristine: 1.4 mg/m² IV (max 2 mg) on Day 1
- Prednisone: 40 mg/m² PO daily on Days 1–5
Cycle repeated every 21 days × 6–8 cycles (varies by protocol).
Indications
- Follicular lymphoma (front-line or relapsed, when anthracyclines not used).
- Other low-grade B-cell non-Hodgkin lymphomas.
- Sometimes used in elderly or anthracycline-ineligible patients (alternative to R-CHOP).
Toxicities / Monitoring
- Rituximab: Infusion reactions, hepatitis B reactivation (screen prior), cytopenias.
- Cyclophosphamide: Myelosuppression, hemorrhagic cystitis (hydrate, monitor urine).
- Vincristine: Neurotoxicity (peripheral neuropathy, constipation/ileus), no intrathecal use.
- Prednisone: Hyperglycemia, mood changes, immunosuppression, osteoporosis.
Monitoring: CBC, LFTs, renal function, hepatitis B status, neurologic assessment, glucose.
Comparison to R-CHOP
- R-CVP excludes doxorubicin (the anthracycline in CHOP).
- Used in patients who cannot tolerate anthracyclines (e.g., elderly, cardiac comorbidity).
- Less intensive, but also generally less effective in aggressive lymphomas.
Key Pharmacist Point: R-CVP is a non-anthracycline regimen for indolent lymphomas, often chosen for patients not fit for R-CHOP.
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