1. Efficacy and Safety of the Modified EPOCH Regimen (Etoposide, Vincristine, Doxorubicin, Carboplatin, and Prednisolone) for Adult T-cell Leukemia/Lymphoma: A Multicenter Retrospective Study
- Author
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Yu Yagi, Eriko Nakashima, Motohiko Ikeda, Yoshimichi Tachikawa, Eriko Fujioka, Takamitsu Matsushima, Hayato Utsunomiya, Youko Suehiro, Tatsuro Goto, Akiko Takamatsu, Hiroshi Takatsuki, Hirofumi Ohno, Taisuke Narazaki, Hiroki Muta, Makoto Oyama, Akie Hirata, Mariko Tsuda, Mitsuo Kozuru, Yuji Yufu, Ilseung Choi, Naokuni Uike, Emi Tanaka, Shojiro Haji, Kaname Miyashita, Junichi Kiyasu, Yasuhiro Tsukamoto, and Yasuhiro Nakashima
- Subjects
Adult ,Male ,Cancer Research ,Vincristine ,medicine.medical_specialty ,Gastroenterology ,Adult T-cell leukemia/lymphoma ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Leukemia-Lymphoma, Adult T-Cell ,EPOCH (chemotherapy) ,Cyclophosphamide ,Etoposide ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Hematology ,Middle Aged ,medicine.disease ,Progression-Free Survival ,Carboplatin ,Confidence interval ,Regimen ,Oncology ,chemistry ,Doxorubicin ,030220 oncology & carcinogenesis ,Prednisolone ,Prednisone ,Female ,business ,030215 immunology ,medicine.drug - Abstract
Background We retrospectively analyzed patients with untreated aggressive adult T-cell leukemia/lymphoma who received the modified EPOCH (mEPOCH) regimen. Patients and Methods Patients received up to 6 mEPOCH cycles. Etoposide (50 mg/m2/day), doxorubicin (10 mg/m2/day), and vincristine (0.4 mg/m2/day) were each given as a continuous 96-hour infusion on days 1 to 4. Prednisolone (40 mg/m2/day) was given intravenously or orally on days 1 to 4 and then tapered and stopped on day 7, and carboplatin (dose calculated for each patient individually using Calvert’s formula according to a target under the curve of 3 mg/mL/min) was given as a 2-hour intravenous infusion on day 6. Results In 103 patients, overall response rate and complete response rate were 58% and 25%, respectively. With a median follow-up of 8.9 months, the median survival time was 9.8 months (95% confidence interval, 7.2-13.9 months). The median progression-free survival (PFS) was 4.2 months (95% confidence interval, 3.4-5.7 months). Patients who completed ≥ 4 cycles experienced significantly better overall survival and PFS compared with those who completed Conclusion The mEPOCH regimen is effective with tolerable adverse effects and may be an alternative treatment option for adult T-cell leukemia/lymphoma.
- Published
- 2020
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