Example orders for R-CHOP in lymphoma

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Remember that example order sets that may contain additional information about supportive medications, suggestions for monitoring, hydration, and pre-treatment screening information for chemotherapy regimens are purely anecdotal, provided only as examples of what some other providers may be using, and are typically not based on references in the primary literature.


R-CHOP: Rituximab, Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone

Original references may be found at R-CHOP (Non-Hodgkin lymphoma)

Example regimen #1

21-day cycles x 6 cycles

Supportive therapy


  • Prehydration with 500 ml NS at 500 mL/hour, to start 60 minutes before chemotherapy
  • 500 ml NS at KVO rate to be used as running IV for chemotherapy infusion. Give up to 500 ml NS.


  • On day 1 of each cycle: CBC with differential, absolute neutrophil count (ANC), BUN/Cr as part of a comprehensive metabolic panel, alk phos, AST, ALT, total bilirubin, albumin, LDH
    • Physician to be notified if liver function tests or bilirubin are not within normal limits
  • On day 8, check nadir CBC with differential, absolute neutrophil count (ANC). Need for further nadir count checks to be determined by degree of cytopenias.
  • Check hepatitis B status prior to therapy with rituximab

Outpatient medications:

Clinical scenario & comments:

  • 74 year-old gentleman with diffuse large B-cell lymphoma (DLBCL), using R-CHOP as first-line therapy. This patient had a creatinine of 1.4, with calculated creatinine clearance by Cockcroft-Gault of 55, but the team chose to be more conservative with allopurinol dosing and used 100 mg PO daily.