New Zealand Formulary
Menu Close Menu

Fewer cancers.
Better survival.
Equity for all.

Systemic Anti-Cancer Therapy Regimen Library

Home > LYM NHL - CHOP21 [CYCLOPHOSPHamide, DOXOrubicin, vinCRISTine and prEDNISone]

LYM NHL - CHOP21 [CYCLOPHOSPHamide, DOXOrubicin, vinCRISTine and prEDNISone]

Treatment Overview

Usually 6 to 8 cycles.

Cycles 1 to 8 - 21 days

Cycle length:
21

Cycle details

Cycles 1 to 8 - 21 days

Medication Dose Route Days Max Duration
prEDNISone 100 mg flat dosing Once daily oral administration 1 to 5
DOXOrubicin 50 mg/m² intravenous 1 15 minutes
vinCRISTine 1.4 mg/m² Cap dose per administration at: 2 mg intravenous 1 10 minutes
CYCLOPHOSPHamide 750 mg/m² intravenous 1 60 minutes

Full details

Cycles 1 to 8 - 21 days

Day: 1

Medication Dose Route Max duration Details
prEDNISone 100 mg flat dosing Once daily oral administration
Instructions:
Take in the morning with food.
DOXOrubicin 50 mg/m² intravenous 15 minutes
Instructions:
Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.
vinCRISTine 1.4 mg/m² Cap dose per administration at: 2 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.
CYCLOPHOSPHamide 750 mg/m² intravenous 60 minutes

Day: 2

Medication Dose Route Max duration Details
prEDNISone 100 mg flat dosing Once daily oral administration
Instructions:
Take in the morning with food.

Day: 3

Medication Dose Route Max duration Details
prEDNISone 100 mg flat dosing Once daily oral administration
Instructions:
Take in the morning with food.

Day: 4

Medication Dose Route Max duration Details
prEDNISone 100 mg flat dosing Once daily oral administration
Instructions:
Take in the morning with food.

Day: 5

Medication Dose Route Max duration Details
prEDNISone 100 mg flat dosing Once daily oral administration
Instructions:
Take in the morning with food.

Supportive Care Factors

Factor Value
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis may be considered
Constipation risk: laxatives are usually prescribed
Emetogenicity: Medium
Gastroprotection: Gastroprotection may be considered
Growth factor support: Variable
Tumour lysis syndrome prophylaxis: Tumour lysis syndrome prophylaxis is recommended

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.

Growth factor support: Consider primary prophylaxis for patients over 64 years of age or other high-risk patients.

Tumour lysis syndrome prophylaxis: Recommended for cycle 1 and consider for subsequent cycles.

References

Pfreundschuh, M. G., L. Trumper, D. Ma, et al. 2004. "Randomized intergroup trial of first line treatment for patients less than 60 years with diffuse large B-cell non-Hodgkin's lymphoma (DLBCL) with a CHOP-like regimen with or without the anti-CD20 antibody Rituximab - early stopping after the first interim analysis." Journal of Clinical Oncology, ASCO Annual Meeting Proceedings 22(14S).

Fisher, R. I., E. R. Gaynor, S. Dahlberg, et al. 1993. "Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma." N.Engl.J.Med. 328(14):1002-1006., PMID: 7680764

Messori, A., M. Vaiani, S. Trippoli, et al. 2001. "Survival in patients with intermediate or high grade non-Hodgkin's lymphoma: meta-analysis of randomized studies comparing third generation regimens with CHOP." Br.J.Cancer. 84(3):303-307., PMID: 11161392

Pfreundschuh, M., L. Trumper, M. Kloess, et al. 2004. "Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL." Blood. 104(3):626-633., PMID: 14982884

Pfreundschuh, M., L. Trumper, M. Kloess, et al. 2004. "Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the DSHNHL." Blood. 104(3):634-641. , PMID: 15016643

Ohmachi K, Tobinai K, Kobayashi Y,et al; Lymphoma Study Group of the Japan Clinical Oncology Group. Phase III trial of CHOP-21 versus CHOP-14 for aggressive non-Hodgkin's lymphoma: final results of the Japan Clinical Oncology Group Study, JCOG 9809. Ann Oncol 2011;22(6):1382-91., PMID: 21196441

Pfreundschuh M, Kuhnt E, Trumper L, Osterborg A, Trneny M, Shepherd L, Gill DS, Walewski J. Randomised intergroup trial of first line treatment for young low-risk patients (less than 61 years) with diffuse large B-cell non-Hodgkin's lymphoma with a CHOP-like regimen with or without the anti-CD20 antibody Rituximab : 6year follow-up of the Mint study of the Mabthera International Trial (MInT) group (abstract 111). Blood 2010;116:55.

Coiffier, B., C. Thieblemont, E. Van Den Neste, et al. 2010. "Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing Rituximab-CHOP to standard CHOP chemotherapy in DLBCL patients: a study by the Groupe d'Etudes des Lymphomes de l'Adulte." Blood 116(12):2040-2045., PMID: 20548096

Coiffier, B., E. Lepage, J. Briere, et al. 2002. "CHOP chemotherapy plus Rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma." N.Engl.J.Med. 346(4):235-242., PMID: 11807147

* 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.