Efficacy and Safety of the Modified EPOCH Regimen (Etoposide, Vincristine, Doxorubicin, Carboplatin, and Prednisolone) for Adult T-cell Leukemia/Lymphoma: A Multicenter Retrospective Study

Yasuhiro Tsukamoto, Junichi Kiyasu, Ilseung Choi, Mitsuo Kozuru, Naokuni Uike, Hayato Utsunomiya, Akie Hirata, Eriko Fujioka, Hirofumi Ohno, Eriko Nakashima, Yasuhiro Nakashima, Kaname Miyashita, Yoshimichi Tachikawa, Taisuke Narazaki, Mariko Tsuda, Shojiro Haji, Akiko Takamatsu, Emi Tanaka, Tatsuro Goto, Hiroshi TakatsukiMakoto Oyama, Hiroki Muta, Yu Yagi, Motohiko Ikeda, Takamitsu Matsushima, Yuji Yufu, Youko Suehiro

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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 < 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.

Original languageEnglish
JournalClinical Lymphoma, Myeloma and Leukemia
DOIs
Publication statusAccepted/In press - Jan 1 2020
Externally publishedYes

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All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology
  • Cancer Research

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