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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
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.
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.
