Combination chemotherapy with more than one chemotherapy agent is usually reserved for advanced stages (Stage III and IV) of CTCL or that are resistant to other forms of therapy or in the treatment of large cell transformation of CTCL.***
One common combination chemotherapy regimen that is utilized is CHOP which stands for the combination of cyclophosphamide, adriamycin, vincristine and prednisone. Cyclophosphamide and prednisone (see oral corticosteroids) have been described elsewhere in this document. In the CHOP regimen, cyclophosphamide is administered intravenously (in a vein). Vincristine is administered in a vein and can cause abdominal cramps and constipation, or numbness and tingling of the feet and hands (peripheral neuropathy). Adriamycin is a red liquid that is administered intravenously. It can cause temporary hair loss (beginning about 2 weeks after the first treatment), nausea or vomiting, lowered blood counts (increased risk of infection with lowered white blood count, bruising or bleeding with lowered platelet count, or tiredness or breathlessness with anemia or lowered red blood cells), sores in the mouth, reddish colored urine, or heart failure in higher lifetime doses.