R - CHOP regimen includes Rituximab Cyclophosphamide Hydroxydaunorubicin Oncovin or vincristine Prednisolone The patient is suffering from distal symmetric neuropathy in a stocking and glove like distribution which is a characteristic side effect of vincristine, a vinca alkaloid. Vinca alkaloids: Mechanism of action: Inhibition of tubulin polymerization, which disrupts assembly of microtubules (pa of cytoskeleton) and the mitotic spindle. This inhibitory effect results in mitotic arrest in metaphase, bringing cell division to a halt, which then leads to cell death. ADVERSE EFFECTS: At clinically used (intravenous) doses, neurotoxicity: glove-and-stocking neuropathy. Acute neuropathic effects include jaw pain, paralytic ileus, urinary retention, and the SIADH secretion.