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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Tsukamoto Y, Kiyasu J, Choi I, Kozuru M, Uike N, Utsunomiya H, Hirata A, Fujioka E, Ohno H, Nakashima E, Nakashima Y, Miyashita K, Tachikawa Y, Narazaki T, Tsuda M, Haji S, Takamatsu A, Tanaka E, Goto T, Takatsuki H, Oyama M, Muta H, Yagi Y, Ikeda M, Matsushima T, Yufu Y, and Suehiro Y
- Subjects
- Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols pharmacology, Cyclophosphamide pharmacology, Cyclophosphamide therapeutic use, Doxorubicin pharmacology, Doxorubicin therapeutic use, Etoposide pharmacology, Etoposide therapeutic use, Female, Humans, Leukemia-Lymphoma, Adult T-Cell mortality, Leukemia-Lymphoma, Adult T-Cell pathology, Male, Middle Aged, Prednisone pharmacology, Prednisone therapeutic use, Progression-Free Survival, Retrospective Studies, Vincristine pharmacology, Vincristine therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Leukemia-Lymphoma, Adult T-Cell drug therapy
- 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/m
2 /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 < 4 cycles. Twenty-eight patients underwent allogeneic hematopoietic stem cell transplantation after mEPOCH and demonstrated significantly prolonged overall survival and PFS compared with those who did not undergo transplantation., Conclusion: The mEPOCH regimen is effective with tolerable adverse effects and may be an alternative treatment option for adult T-cell leukemia/lymphoma., (Copyright © 2020 Elsevier Inc. All rights reserved.)- Published
- 2020
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