Dose-adjusted EPOCH with or without rituximab for aggressive lymphoma patients: real world data
- PDF / 561,265 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 5 Downloads / 186 Views
ORIGINAL ARTICLE
Dose‑adjusted EPOCH with or without rituximab for aggressive lymphoma patients: real world data Shinichiro Matsuda1 · Ritsuro Suzuki1 · Tsutomu Takahashi1 · Youko Suehiro2 · Naoto Tomita3 · Koji Izutsu4 · Noriko Fukuhara5 · Yoshitaka Imaizumi6 · Kazuyuki Shimada7 · Tomonori Nakazato8 · Isao Yoshida9 · Kana Miyazaki10 · Motoko Yamaguchi10 · Junji Suzumiya1 Received: 11 March 2020 / Revised: 11 August 2020 / Accepted: 25 August 2020 © Japanese Society of Hematology 2020
Abstract CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) −/+ rituximab (R) is the standard chemotherapeutic regimen for aggressive lymphoma, but is insufficient for aggressive lymphoma with adverse prognostic factors. Dose-adjusted (DA)-EPOCH (etoposide, doxorubicin, cyclophosphamide, vincristine, and prednisolone) −/+ R demonstrates excellent efficacy against some aggressive lymphoma. Thus, we conducted a retrospective study to evaluate the feasibility and efficacy of this therapy in clinical practice. We enrolled 149 patients from 17 institutions diagnosed between 2007 and 2015. The median follow-up period for survivors was 27 months (range 0.2–123). The complete response (CR) rate of newly diagnosed patients was 79% (95% CI 68–87%). All patients were hospitalized to receive this therapy and 94% of patients also received granulocyte-colony-stimulating factor support. There were no treatment-related deaths. Febrile neutropenia (FN) and grade 3 or 4 infection occurred in 55% and 28% of patients, respectively. There were no significant differences in FN or infection between young (≤ 65 years) and elderly patients (> 65 years). In newly diagnosed diffuse large B-cell lymphoma-not otherwise specified patients (n = 46), the CR rate was 80% (95% CI 64–91%) and the 2-year OS rate was 81% (95% CI 66–90%). In the present study, DA-EPOCH −/+ R exhibited excellent efficacy and feasibility for aggressive lymphoma. Keywords DA-EPOCH · Lymphoma · DLBCL
Introduction Aggressive lymphomas are heterogeneous, but potentially curative diseases. CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) therapy had been the standard chemotherapeutic regimen for the majority of aggressive
6
Department of Hematology, Nagasaki University, Nagasaki, Japan
7
Department of Hematology, Nagoya University Hospital, Nagoya, Japan
8
Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
Department of Hematology, Yokohama Municipal Citizens Hospital, Yokohama, Japan
9
Department of Hematology, St. Marianna University School of Medicine, Kawasaki, Japan
Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
10
* Junji Suzumiya [email protected]‑u.ac.jp 1
2
3
Innovative Cancer Center/Oncology‑Hematology, Shimane University Hospital, 89‑1 Enya, Izumo, Shimane 693‑8501, Japan
4
Department of Hematology, Toranomon Hospital, Tokyo, Japan
5
Department of Hematology, Tohoku University Hospital, Sendai, Japan
l
Data Loading...
