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Systemic Anti-Cancer Therapy Regimen Library

Home > LYM HL Advanced - ChIVPP [chlorambucil, vinBLASTine, procarbazine and prEDNISone]

LYM HL Advanced - ChIVPP [chlorambucil, vinBLASTine, procarbazine and prEDNISone]

Treatment Overview

Number of cycles: 6 to 8 cycles (complete remission plus 2 further cycles).

Cycles 1 to 8 - 28 days

Cycle length:
28

Cycle details

Cycles 1 to 8 - 28 days

Medication Dose Route Days Max Duration
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration 1 to 14
vinBLASTine * 6 mg/m² Cap dose per administration at: 10 mg intravenous 1, 8 10 minutes
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration 1 to 14
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration 1 to 14

Full details

Cycles 1 to 8 - 28 days

Day: 1

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
vinBLASTine * 6 mg/m² Cap dose per administration at: 10 mg intravenous 10 minutes
Instructions:
  • Diluted in a minibag.
  • FOR INTRAVENOUS USE ONLY – fatal if given by any other routes.
  • Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 2

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 3

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 4

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 5

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 6

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 7

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 8

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
vinBLASTine * 6 mg/m² Cap dose per administration at: 10 mg intravenous 10 minutes
Instructions:
  • Diluted in a minibag.
  • FOR INTRAVENOUS USE ONLY – fatal if given by any other routes.
  • Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 9

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 10

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 11

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 12

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 13

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Day: 14

Medication Dose Route Max duration Details
prEDNISone 40 mg/m² Once daily Cap dose per administration at: 60 mg oral administration
Instructions:

Take in the morning with food.
procarbazine 100 mg/m² Once daily Cap dose per administration at: 150 mg oral administration
Instructions:
  • Take with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.
chlorambucil 6 mg/m² Once daily Cap dose per administration at: 10 mg oral administration
Instructions:
  • Always take at the same time in relation to food, preferably take at least one hour before, or 3 hours after food or take with food if significant gastric toxicity occurs.
  • Round dose to closest multiple of 2 mg tablets.
  • KEEP IN FRIDGE - DO NOT FREEZE.

Supportive Care Factors

Factor Value
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis may be considered
Constipation risk: laxatives are usually prescribed
Emetogenicity: Medium to high
Gastroprotection: Gastroprotection may be considered
Irradiated blood components: Irradiation of blood components is recommended
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: Routine antibiotic prophylaxis recommended
Tumour lysis syndrome prophylaxis: Tumour lysis syndrome prophylaxis may be considered

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.

Irradiated blood components: Required for Hodgkin lymphoma patients at all stages of disease and therapy. Continue indefinitely.

References

ChlVPP therapy for Hodgkin's disease: experience of 960 patients. The International ChlVPP Treatment Group. Ann Oncol. 1995 Feb;6(2):167-72. , PMID: 7786824

Holte, H., O. Mella, E. Wist, et al. 1996. "ChlVPP is as effective as alternating ChlVPP/ABOD in advanced stage Hodgkin's disease." Acta Oncol. 35 Suppl 8:73-80.:73-80., PMID: 9073051

Selby, P., P. Patel, S. Milan, et al. 1990. "ChlVPP combination chemotherapy for Hodgkin's disease: long-term results." Br.J.Cancer. 62(2):279-285., PMID: 2386744

McElwain TJ, Toy J, Smith E et al.A combination of chlorambucil, vinblastine, procarbazine and prednisolone for treatment of Hodgkin's disease. Br J Cancer 1977 Aug;36(2):276-80, PMID: 911666

New Zealand Blood Service Transfusion Medicine Handbook Third Edition, 2016 https://www.nzblood.co.nz/assets/Transfusion-Medicine/PDFs/111G122.pdf (accessed 3/2/2022).

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.