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1. What This Treatment Is
Pola-R-CHP is used for diffuse large B-cell lymphoma.
It is given in 6 cycles, usually every 21 days.
Day 1 of each cycle: you receive rituximab, polatuzumab vedotin, cyclophosphamide, and doxorubicin by IV infusion in the clinic.
Prednisone tablets are usually taken at home on Days 1-5 of each cycle to help the treatment work and lower reaction risk.
The first cycle’s infusions may be given more slowly so the team can watch for infusion reactions.
The goal of treatment is to shrink or eliminate lymphoma cells—for many people this offers a chance for cure.
2. How to Take Prednisone
Take once each morning (before 9–10 AM) on Days 1-5 of each cycle.
Always take with food and a full glass of water to protect your stomach.
Swallow whole; do not crush unless told otherwise.
Do not skip or stop early unless your doctor says so—sudden stopping can be harmful.
If you miss a dose, take it the same day when remembered; if near the next dose, skip the missed one (don’t double up).
Possible short-term effects: increased appetite, mood changes, jitteriness, higher blood sugar, and trouble sleeping—take early in the day and report anything severe.
3. Common and Serious Side-Effects
Common: tiredness, nausea, diarrhea or constipation, hair loss, mouth sores, skin or nail changes, loss of appetite, numbness/tingling in fingers or toes. Blood-count changes: low white cells → infection risk; low red cells → fatigue; low platelets → easy bruising/bleeding. Serious risks:
Febrile neutropenia – fever with very low white cells
Infections (lungs, urinary tract, etc.)
Peripheral neuropathy – tingling/numbness that can worsen with each cycle
Heart problems – doxorubicin may affect the heart muscle
Severe diarrhea or mouth sores
4. Red-Flag Symptoms – Call Right Away
Symptom
Why Important
What to Do
Fever ≥ 100.4 °F / 38 °C, chills, cough, burning on urination
Possible infection during low white-cell counts
Call the cancer team immediately – day or night
Shortness of breath, chest pain, swelling, sudden weight gain
Could be heart-related or severe reaction
Call right away or go to ER / 911
Flushing, itching, rash, throat tightness, dizziness during infusion
Possible infusion reaction
Alert nurse immediately
New or worsening numbness/tingling in hands or feet
Nerve side-effect from polatuzumab
Report promptly at next visit or sooner if worsening
Uncontrolled nausea/diarrhea/constipation or mouth sores
May need early treatment
Call clinic
Red-colored urine for 1–2 days after infusion
Expected from doxorubicin dye
Call only if it lasts > 2 days, is painful, or appears bloody
5. Staying Safe at Home
Hand hygiene: wash hands often and ask visitors to do the same.
Avoid sick contacts & crowded indoor spaces when your counts are low; consider masking.
Keep a thermometer at home; check your temperature if you feel unwell.
Stay hydrated and eat small, frequent meals.
Use your anti-nausea and other supportive medicines exactly as prescribed.
Avoid grapefruit or grapefruit juice while on cyclophosphamide—it can change how the drug is processed.
Protect skin & scalp from sun; use moisturizer.
Mouth care: gentle, alcohol-free rinses after meals can reduce mouth sores.
Bring all medicines & supplements to appointments and check with your team before adding new ones.
6. Longer-Term Considerations
Fertility: chemotherapy can affect reproductive health—ask about options before treatment starts.
Peripheral neuropathy can sometimes persist or worsen—report early so doses can be adjusted.
Heart health: let your team know about any history of heart disease or new shortness of breath, swelling, or cough.
7. Emotional & Practical Support
Feeling tired often increases over successive cycles—rest as needed but try gentle activity (like short walks) to preserve strength.
Seek help from family, caregivers, counseling, or support groups—emotional support is an important part of recovery.
8. Emergency & Contact Information
Your cancer center will provide a 24-hour contact phone number—keep it by your phone and bring it to all visits.
Call anytime for fever, chest pain, trouble breathing, or any symptom that feels alarming.
Call 911 for severe breathing difficulty or chest pressure.
Key Take-Home Message
Pola-R-CHP is an effective regimen for many people with DLBCL. Promptly report fevers or new/worsening symptoms, follow prednisone instructions carefully, and stay in close touch with your care team—this helps keep you safe and on track with treatment.
References
Adapted from Macmillan Cancer Support, eviQ, Polivy® patient materials, NIH/NCBI, Mayo Clinic, ASH Blood, and ChemoExperts.
