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Related Experiment Videos

[EPOCH therapy for relapsed/refractory lymphoid malignancies]

N Dobashi1, N Usui, T Kobayashi

  • 1Department of Hematology/Oncology, Jikei University Hospital.

[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|May 23, 1998
PubMed
Summary

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Continuous infusion EPOCH therapy shows effectiveness in patients with refractory non-Hodgkin's lymphoma (NHL) and leukemia, including acute lymphocytic leukemia (ALL). This approach may overcome resistance to standard bolus infusions of these chemotherapy drugs.

Area of Science:

  • Oncology
  • Hematology
  • Pharmacology

Background:

  • Patients with refractory or relapsed hematologic malignancies often exhibit resistance to standard chemotherapy.
  • Previous treatments with doxorubicin (DOX), vincristine (VCR), and other agents may not induce durable responses.

Purpose of the Study:

  • To evaluate the efficacy and toxicity of EPOCH therapy administered via continuous infusion in patients with refractory or relapsed non-Hodgkin's lymphoma (NHL), acute T-cell leukemia (ATL), ATL lymphoma, and acute lymphocytic leukemia (ALL).
  • To determine if continuous infusion of chemotherapy agents can overcome resistance observed with bolus administration.

Main Methods:

  • A cohort of 21 patients with refractory/relapsed NHL, ATL, ATLL, or ALL received EPOCH therapy.
  • EPOCH regimen included continuous infusion doxorubicin (DOX), vincristine (VCR), etoposide (ETP), with intravenous cyclophosphamide and oral prednisolone.

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  • Patient response and toxicity were assessed throughout the treatment course.

    • Main Results:

    • Complete remission was achieved in 2 patients (1 ALL, 1 NHL).
    • Partial remission was observed in 3 patients (2 NHL, 1 ATLL).
    • Common hematological toxicities included neutropenia (83.3%), anemia (76.7%), and thrombocytopenia (76.7%); non-hematological toxicities like nausea, vomiting, and infection were generally manageable.

    Conclusions:

    • Continuous infusion EPOCH therapy demonstrates potential efficacy in heavily pre-treated patients with refractory/relapsed hematologic malignancies.
    • This delivery method may offer a viable alternative for patients resistant to bolus chemotherapy regimens.