What are the side effects of the CHOP (Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone) chemotherapy regimen?

From the Guidelines

The CHOP chemotherapy regimen is associated with several side effects, including hair loss, nausea, vomiting, fatigue, and increased risk of infections due to lowered white blood cell counts, as reported in studies such as 1 and 1.

Common Side Effects

• Hair loss (alopecia)
• Nausea and vomiting
• Fatigue
• Increased risk of infections due to lowered white blood cell counts (neutropenia)
• Mouth sores (mucositis)
• Loss of appetite and taste changes

Drug-Specific Side Effects

• Cyclophosphamide: bladder irritation and bleeding (hemorrhagic cystitis) 1
• Hydroxydaunorubicin (doxorubicin): heart damage (cardiotoxicity), especially at higher cumulative doses 1
• Oncovin (vincristine): nerve damage (peripheral neuropathy), resulting in numbness, tingling, or pain in hands and feet
• Prednisone: mood changes, increased appetite, weight gain, fluid retention, elevated blood sugar, and sleep disturbances

Management of Side Effects

• Supportive medications are usually prescribed to manage symptoms
• Patients should drink plenty of fluids to reduce the risk of hemorrhagic cystitis
• Blood counts typically reach their lowest point 7-14 days after treatment, when infection risk is highest
• The use of hematopoietic growth factors, such as G-CSF, can reduce the risk of febrile neutropenia, as shown in studies such as 1

Patient-Specific Considerations

• Elderly patients may require modified treatment regimens, such as R-miniCHOP, to reduce the risk of side effects 1
• Patients with cardiac dysfunction or other comorbidities may require substitution or omission of certain drugs, such as doxorubicin 1

From the Research

Side Effects of CHOP Chemotherapy Regimen

The CHOP chemotherapy regimen, which consists of Cyclophosphamide, Hydroxydaunorubicin, Oncovin, and Prednisone, is commonly used to treat non-Hodgkin's lymphoma. The side effects of this regimen have been studied in various research papers.

• Common side effects include:
  • Alopecia (hair loss) 2
  • Fatigue 2
  • Taste change 2
  • Nausea and vomiting 2, 3
  • Constipation 2
  • Difficulty sleeping 2
  • Neutropenia (low white blood cell count) 4
  • Anemia 4
  • Increased risk of infections 4, 5, 6
• Less common but serious side effects include:
  • Severe neutropenia 4
  • Treatment-related mortality 5, 6
  • Development of secondary cancers such as acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) 6
• The severity and frequency of these side effects can vary depending on the individual patient and the specific treatment protocol being used.
• Research has also shown that the side effects of CHOP can be reduced by using alternative treatment regimens, such as four cycles of R-CHOP instead of six cycles 5.
• Additionally, the use of supportive care measures such as anti-emetics and growth factors can help to mitigate some of the side effects of CHOP chemotherapy 3, 4.