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Information leaflet about R-CHOP

This leaflet provides information about a course of treatment called R-CHOP. The leaflet will explain what this is and how and when it will be given. It will also tell you about any common side effects you may experience. Contact telephone numbers and details of how to get more information about R-CHOP are at the end of this leaflet.


You should read this leaflet alongside the ' General information for patients undergoing chemotherapy' leaflet. If you have not received this leaflet, ask your nurse for a copy.


What is R-CHOP treatment?

This is a treatment that includes a combination of drugs that work in different ways to treat your cancer.


  1. Rituximab (commonly called Mabthera)

This is an artificial antibody that attaches itself to lymphoma cancer cells. It is not chemotherapy. Mabthera helps your immune system to kill the cancer cells.


This is the R part of the treatment.


  1. Chemotherapy treatment

This part of the treatment consists of four drugs. There are three chemotherapy drugs that are given through a drip:

  • Cyclophosphamide
  • Doxorubicin
  • Vincristine


The last drug is a steroid tablet called prednisolone.


This is the CHOP part of the treatment.



Why am I having R-CHOP treatment?

Your doctor has recommended this treatment as this combination is highly effective in treating the type of cancer you have.



How often will I receive my treatment?

In order for this treatment to be most effective, it is given at specific time intervals. These are called circles. An R-CHOP cycle lasts three weeks. It is normal to have between six and eight cycles. Your doctor will discuss with you the exact number of cycles you will have.


You will be given the Mabthera and the chemotherapy drugs once every three weeks. The prednisolone tablets are given for five days, starting on the same day as the other drugs.


How long will I be in hospital?

Your treatment will usually be on a different day to your clinic appointment.


The Mabthera treatment will take approximately 4 hours for the first treatment, and 2 1/2 hours for the subsequent treatments.

The chemotherapy treatment will take approximately 30 minutes.


You are welcome to bring someone to stay with you during your treatment. There is limited space in the waiting areas and the treatment room, so there is usually no room for more than one person. The treatment areas are not suitable for young children.



How is Mabthera given?

Before you start getting Mabthera, you will be given paracetamol and drugs called piriton (chlorpheramine) and hydrocortisone. These are given to prevent the side effects that may occur during the treatment.


Mabthera is given by a drip into a vein in the back of your hand or arm. Alternatively, we may suggest that a thin tube called a PICC is inserted into one of the large veins in your upper arm. This can remain in place throughout your treatment. Your doctor or nurse will discuss this further with you.


We have a leaflet that tells you more about PICC lines. Please ask if you would like a copy.



What are the side effects of Mabthera treatment?

Reactions during treatment

Most of the side effects that can occur with Mabthera occur while the drug is infusing. This is why the first treatment is given more slowly. We will monitor you closely during the treatment. This will include checking your temperature and blood pressure regularly.


If you experience any of the following during treatment, tell your nurse straight away:


  • Feeling hot and feverish
  • Numbness or tremors
  • headache
  • Dizziness or weakness
  • Breathing problems
  • Itchy skin
  • Throat tingling


If you experience any of these, we will slow down or stop the Mabthera until you feel better. The treatment can then start again, usually without any further problems.



Side effects following treatment

You may suffer from fatigue, headache or dizziness. Tell your doctor at your next appointment at the lower clinic if these are causing you a problem. You should not drive on the day of treatment or while you are affected by these side effects.


How will my chemotherapy be given?

Before your chemotherapy, we will give you the prednisolone tablets and some anti-nausea tablets. There are 20 small prednisolone tablets.


The chemotherapy will be given through a drip.



What are the possible side effects of CHOP chemotherapy?

There are a number of possible side effects that you may experience with this chemotherapy. The doctors, nurses and pharmacists can give you advice or answer any questions you may have.


Loss of hair

Unfortunately, you will lose your hair with this chemotherapy. This will be temporary. Your hair will grow back after you finish the treatment. We can arrange a wig if you would like one. Ask your nurse for more information.  


We have a leaflet that tells you more about coping with hair loss. Ask your nurse if you would like a copy.



Nausea and vomiting are now uncommon as we will give you anti-nausea medicines, which are usually very effective. If you vomit more than once in 24 hours, even though you regularly take anti-nausea medication when you are home after your chemotherapy treatment, contact Felindre Cancer Center for advice. The phone number is on page 8.




Your risk of catching infections will be higher as this treatment can reduce your white blood cells which help fight infections. Contact Velindre Cancer Center immediately if you develop any signs of infection, for example, flu-like symptoms or a temperature above 37.5°C. The phone number is on a page.



Diarrhea is not common with this chemotherapy. However, if you open your bowel four times or more than is normal for you within 24 hours, contact Velindre Cancer Center immediately. The phone number is on page 8.


Fatigue and fatigue

Chemotherapy can make you feel more tired than usual. It is important to listen to your body and rest if you need to but you should continue with your normal activities if you feel able to do so. For some people, a little exercise can be beneficial as well as rest.


Sore mouth

Your mouth may be sore or you may notice small ulcers. Follow the advice on looking after your mouth in the general chemotherapy leaflet. Your doctor may give you a prescription for mouthwash or medication to prevent or clear up any infection.


Effects on your nerves

Vincristine can affect the nerves in your fingers and toes, causing numbness or tingling. It can also affect the nerves to your gut. This can lead to constipation. Some patients may also suffer from pain in their mouth or headache if the nerves to the head are affected. If you develop any of these problems, tell your doctor or nurse at your next clinic visit.




Other side effects


Doxorubicin can occasionally cause heart problems. If you have a heart condition or are taking any heart medicine, tell your doctor before you start chemotherapy.


Doxorubicin will discolor your urine red. This is completely harmless. If this lasts for more than 24 hours, contact Velindre Cancer Center immediately. The phone number is on page 8.


Chemotherapy treatment sometimes affects women's periods. They could get heavier, lighter or even stop altogether.


It is important that you do not become pregnant or become a father while you are having chemotherapy treatment as chemotherapy could harm the unborn baby.



Patient information leaflets from manufacturers

Copies of patient information leaflets from drug manufacturers are available from Felindre Pharmacy, or on the internet at These leaflets give detailed information about individual drugs. We do not routinely distribute them as they do not usually provide information on drug combinations and can be difficult to read. Please ask if you would like a copy.








Contact telephone numbers


Felindre Cancer Center 029 2061 5888

Ask for the chemotherapy pager if you get sick at home and need immediate attention at any time of the day or night. For example, you should call in the case of:

  • If you vomit more than once over a 24 hour period
  • That you have a temperature of 37.5°C or higher
  • That you have diarrhoea
  • That you have red urine for more than 24 hours


Pharmaceutical department 029 2061 5888 ext. 6223

Monday – Friday 9am – 5pm for inquiries about your medicines



Cancer helpline

Tenovus freephone 0808 808 1010

Monday – Friday 9am – 4.30pm for general cancer enquiries












This leaflet has been written by health professionals. The information in this leaflet is based on evidence. The leaflet was endorsed by doctors, nurses and patients. It is reviewed and updated every two years.