Long-term Survival Following EPOCH Therapy with Allogeneic Hematopoietic Stem Cell Transplantation for Relapsed or Refractory Peripheral T-cell Lymphoma: A report of Three Cases

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 Relapsed or refractory peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) and angioimmunoblastic T-cell lymphoma (AITL) are associated with a poor prognosis and recommended for allogeneic stem cell transplantation (SCT). However, there is no consensus on salvage chemotherapy prior to allogeneic SCT. Here, we describe three patients with relapsed or refractory PTCL-NOS or AITL successfully treated with EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) before allogeneic SCT. Despite receiving pirarubicin as part of the initial therapy, no patient developed cardiac failure throughout allogeneic SCT, possibly due to the continuous infusion schedule of EPOCH and conditioning regimen. To date, the patients remain in CR over 5 years after allogeneic SCT with no significant complications. We suggest that the EPOCH regimen is one of the treatment options available as salvage therapy prior to allogeneic SCT to reduce the tumor burden of lymphoma without severe adverse events.