CEPP

CEPP is an acronym for the name of a chemotherapy regimen that is intended for treatment of aggressive Non-Hodgkin Lymphomas. Unlike CHOP, this chemotherapy regimen does not contain doxorubicin or any other anthracycline. Thus, it can be used in patients with severe cardiovascular diseases and contraindications for doxorubicin-containing regimens. There are 2 modifications of CEPP - with the addition of bleomycin, called CEPP (B), and without bleomycin - ordinary CEPP.^[1]

This regimen also does not contain vincristine and can be used in patients with neuropathy.

In combination with anti-CD20, monoclonal, antibody, and rituximab. this regimen is called R-CEPP(B).

[R]-CEPP(B) regimen consists of:

1. (R)ituximab - a monoclonal antibody that is able to kill CD20-positive B cells, either normal or malignant;
2. (C)yclophosphamide - an alkylating antineoplastic agent;
3. (E)toposide - a topoisomerase inhibitor from the epipodophyllotoxin group;
4. (P)rocarbazine - an alkylating antineoplastic agent;
5. (P)rednisone or (P)rednisolone - a glucocorticoid hormone that has the ability to cause apoptosis and lysis of lymphocytes, either normal or malignant;
6. (B)leomycin - an antitumor antibiotic.

Dosing regimen

Drug	Dose	Mode	Days
(R)ituximab	375 mg/m^2	IV infusion	Day 1
(C)yclophosphamide	600 mg/m^2	IV infusion	Days 1 and 8
(E)toposide	70 mg/m^2	IV infusion	Days 1-3
(P)rocarbazine	60 mg/m^2	PO qd	Days 1-10
(P)rednisone or (P)rednisolone	60 mg/m^2	PO qd	Days 1-10
(B)leomycin	10 IU/m^2	IV bolus	Day 1

References

1. CEPP (B): an effective and well-tolerated regimen in poor-risk, aggressive non-Hodgkin's lymphoma