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Rituximab reaction - first R-CHOP cycle

LV20
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Hello Wave tone2

My lovey mum started her first chemo cycle today of R-CHOP but unfortunately had 2 infusion reactions. Which meant they decided to stop her first chemo cycle, they offered to continue with just the CHOP but she was too nervous to continue. 

My mum was diagnosed with Grade 3B Follicular lymphoma which is fast growing. Which means it looks like a type of high grade NHL called DLBCL. 

I was wondering if she continues to react to the Rituximab what other treatment options are there for her? They did mention about bringing her in as an inpatient so she could be monitored throughout the night if they do decide to treat her with the R again but very very slowly. 

Any guidance would be super - thank you so much. 

  • Dear LV20,

    Thanks for getting in touch and a warm welcome to the Online Community. I’m Heidi one of the Cancer Information Nurses here on the Macmillan Support Line.

    I can see that you have found our carers only, diffuse large B-cell lymphoma and follicular lymphoma forums, I hope that you are finding them a good source of help and support for you.  It is really important you look after you too.

    I am sorry to read that your mum had a reaction to her first cycle of R-CHOP, it is understandable that she would feel nervous about continuing with her treatment that day.

    Grade 3B follicular lymphoma is usually fast growing.  It is treated the same way as diffuse large B-cell lymphoma (DLBCL), which is a type of high-grade non-Hodgkin lymphoma as you mentioned.  

    Rituximab is normally the targeted treatment of choice.  It is not unusual to have a reaction to Rituximab, and this can be managed by giving drugs to help beforehand, such as steroids or antihistamines. The treatment may be given slowly over a longer period of time, or in hospital as has been suggested for your mum, so that she can be monitored more closely.

    A gentler regime may also be suggested.  R-miniCHOP is where the dose of each drug may be reduced or some of the drugs left out.  R-CEOP uses etoposide instead of doxorubicin.

    If there were concerns regarding a reaction to the Rituximab, then this may be taken out altogether, and she would continue with the CHOP alone.

    We would always recommend talking to your mum’s specialist team about your concerns, as they are best placed to advise about your mum’s individual situation.

    You sound like a wonderful support and I wish your mum the very best with the next steps of her treatment.  Please don’t hesitate to contact us again if we can be of further support.

     

    Best wishes and take care,

     

    Heidi

    Cancer Information Nurse Specialist 

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or email us. 

    Ref/HW/HC

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