R-CHOP is a specific combination of chemotherapy drugs consisting of cyclophosphamide, doxorubicin hydrochloride, vincristine and prednisolone (CHOP), with the addition of rituximab (R). Rituximab is a monoclonal antibody that targets the protein CD20 found on B cells, the cancerous cells of non-Hodgkin's lymphoma. This portion of the treatment therefore helps to target the chemotherapy drugs directly to the cancer cells. However, the chemotherapy drugs still produce a variety of unwanted side effects and, according Biologics, rituximab is also associated with certain side effects.
Common
The most common side effect of the chemotherapy drugs used in R-CHOP is the suppression of bone marrow, which results in low blood cell counts. A reduction in red blood cells can cause anemia, which produces the symptoms of fatigue and shortness of breath. A drop in platelets, which are the cells in the blood responsible for clotting, results in an increase in nosebleeds, bruising and petechia (tiny red spots on the arms or legs). A decrease in white blood cells increases the risk of infection and, according to Cancer Help UK, induces symptoms of headache, muscle ache, cough and sore throat.
Rituximab commonly causes flu-like symptoms including fever, chills and shivering. In addition, the depletion of B cells, according to Biologics, depletes the B cells in the body which can potentially increase the rate of infections.
Other common side effects of the chemotherapy medications include mouth sores, hair loss, abdominal cramps, constipation, tingling fingers or toes, and problems with infertility. Nausea, vomiting and skin rashes are common side effects of both the chemotherapy portion and the rituximab.
Occasional
One of the medications of the R-CHOP treatment, doxorubicin, can occasionally cause more severe reactions. About 3 percent of patients, according to Cancer Help UK, will experience an allergic reaction marked by the sudden appearance of itchy red bumps along the vein where the medication was injected. Doxorubicin is in the anthracycline class of medications, which are known to cause damage to the muscles of the heart, according to the Journal of Hematology and Oncology.
Other occasional side effects induced by the R-CHOP treatment regimen include burning or pain during urination, changes in taste, the appearance of ridges in nails, and diarrhea.
Rare
The R-CHOP chemotherapy treatment can also cause some rare but potentially serious side effects. Cells of the lung tissues can be damaged and cause breathing difficulty. Some chemotherapy treatments, including R-CHOP, increase the risk of later developing other cancers such as leukemia or lymphoma.
