What are the most common side effects of Cyclophosphamide (CY), Hydroxydaunorubicin (DOX), Oncovin (VCR) (Vincristine), and Prednisone chemotherapy?

From the Guidelines

The most common side effects of CHOP chemotherapy include hair loss (alopecia), nausea and vomiting, fatigue, increased risk of infection due to decreased white blood cell counts (neutropenia), mouth sores (mucositis), and peripheral neuropathy (numbness or tingling in hands and feet). CHOP is an acronym for the drugs in this regimen: Cyclophosphamide, Hydroxydaunorubicin (doxorubicin), Oncovin (vincristine), and Prednisone. According to the study by 1, patients with intermediate to high grade NHL who received CHOP chemotherapy experienced a 25% incidence of grade 4 leukopenia and 22% incidence of grade 4 neutropenia.

Side Effects of CHOP Chemotherapy

• Hair loss (alopecia)
• Nausea and vomiting
• Fatigue
• Increased risk of infection due to decreased white blood cell counts (neutropenia)
• Mouth sores (mucositis)
• Peripheral neuropathy (numbness or tingling in hands and feet)

Patients typically experience bone marrow suppression 7-14 days after treatment, leading to low blood counts that increase infection risk. Anti-nausea medications like ondansetron are usually prescribed before and after treatment. Patients should monitor for fever (temperature above 100.4°F/38°C), which could indicate infection requiring immediate medical attention. Hydration is important during treatment to help flush the drugs through the system and reduce side effects. Some side effects like hair loss are temporary, while others like peripheral neuropathy may persist longer. The severity of side effects varies between individuals based on factors such as age, overall health, and specific dosing of the regimen.

The study by 1 also highlights the importance of considering the patient's age and overall health when administering CHOP chemotherapy, as these factors can impact the severity of side effects. Additionally, the study by 1 notes that rituximab maintenance significantly improves PFS and even OS after R-CHOP, which may help mitigate some of the side effects associated with CHOP chemotherapy. However, the most recent and highest quality study 1 does not provide specific information on the side effects of CHOP chemotherapy, but it does emphasize the importance of considering the patient's individual factors when administering this regimen.

From the Research

Common Side Effects of CHOP Chemotherapy

• The most common side effects of CHOP chemotherapy include:
  • Alopecia (hair loss) 2
  • Fatigue 2, 3
  • Taste change 2
  • Nausea and vomiting 2, 3
  • Mucositis 3
  • Dry skin 3
  • Skin rash 3
  • Bowel changes 3
  • Anemia 3
  • Increased risk of infection 3
• Other side effects that have been reported include:
  • Neutropenia (low white blood cell count) 4, 5
  • Thrombocytopenia (low platelet count) 4
  • Febrile neutropenia (fever and low white blood cell count) 4, 5
  • Infection 4, 5
  • Hypokalaemia (low potassium levels) 5
  • Hypertension (high blood pressure) 5
  • Intracerebral haemorrhage (bleeding in the brain) 5