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DA-EPOCH-R for post-transplant lymphoproliferative disorders.

Christin B DeStefano1, Vera Malkovska1, Hind Rafei2

  • 1Department of Hematology, MedStar Washington Cancer Institute, Washington, DC, USA.

European Journal of Haematology
|May 17, 2017
PubMed
Summary

Dose-adjusted (DA)-EPOCH-R chemoimmunotherapy shows promise for treating advanced post-transplant lymphoproliferative disorders (PTLD). This treatment was well-tolerated and achieved complete responses in most patients who completed therapy.

Keywords:
aggressive B-NHLlymphoproliferative diseasesmalignant lymphoma

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Area of Science:

  • Oncology
  • Immunology
  • Hematology

Background:

  • Post-transplant lymphoproliferative disorders (PTLD) are aggressive neoplasms in immunocompromised patients.
  • Reduced immunosuppression (RI) is the primary treatment, but advanced cases require chemoimmunotherapy.
  • The DA-EPOCH-R regimen is effective for HIV-associated lymphomas and may benefit PTLD.

Observation:

  • A retrospective analysis of 7 advanced monomorphic PTLD patients treated with DA-EPOCH-R and RI was conducted.
  • Most patients had kidney transplants, advanced-stage disease, and EBV-positive tumors.
  • Six of seven patients completed therapy, with six achieving a complete response.

Findings:

  • Complete response rates were high (100%) among patients who completed DA-EPOCH-R therapy.
  • Mean progression-free survival (PFS) was 46.6 months, and overall survival (OS) was 52.6 months.
  • Treatment with DA-EPOCH-R was generally well-tolerated, with minimal treatment-related toxicity.

Implications:

  • DA-EPOCH-R is an effective and safe first-line treatment option for advanced monomorphic PTLD.
  • These findings support the use of DA-EPOCH-R in PTLD management, aligning with existing literature.
  • Further research may explore DA-EPOCH-R in broader PTLD populations and compare it with other regimens.