EPOCH Therapy for Relapsed/Refractory Lymphoid Malignancies

Abstract

Patients with refractory or relapsed non-Hodgkin's lymphoma (NHL), acute T-cell leukemia (ATL), ATL lymphoma and acute lymphocytic leukemia (ALL) received EPOCH therapy. All were previously treated with doxorubicin (DOX), vincristine (VCR) and other drugs. The EPOCH treatment schedule is consisted with DOX (10 mg/M²/day, 5days c.i.v.), VCR (0.4 mg/M²/day, 4days c.i.v.), etoposide (50 mg/M²/day, 4days c.i.v.), cyclophosphamide (750 mg/M²/day, day 6 i.v.) and prednisolone (60 mg/M²/day, 5days p.o.). Twenty-one patients (ALL: 10, NHL: 8, ATLL: 2, ATL: 1) were assessable for response and toxicity. Two patients with ALL and NHL, respectively, achieved a complete remission and 3 patients obtained partial remission (NHL: 2, ATLL: 1). The hematological toxicity (grade>1) included neutoropenia, anemia and thrombocytopenia, which were observed in 83.3%, 76.7% and 76.7% respectively, of total 30 EPOCH courses. The major non-hematological toxicities were nausea/vomiting, constipation and infection, but most of the toxicity were tolerable with sufficient clinical supportive care. These results indicate that continuous infusion of DOX, VCR and ETP might be effective in patients who were treated with, and presumed to be resistant to the same drugs administrated by bolus infusion.