3 years ago

Dose-adjusted EPOCH chemotherapy for untreated peripheral T-cell lymphomas: A multicenter phase II trial of West-JHOG PTCL0707.

Nishimori, Matsuo, Yano, Masaki, Hiramatsu, Tanimoto, Takahashi, Nawa, Maeda, Nakamura, Gomyo, Sunami, Masunari, Ohshima, Uno, Yamane, Yoshida, Yoshino
The standard CHOP for peripheral T-cell lymphoma has resulted in unsatisfactory outcomes and optimal frontline therapy remains unclear. We conducted a multicenter phase II study of dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine and prednisone (EPOCH) for untreated peripheral T-cell lymphoma patients. In this prospective study, 41 patients were treated with dose-adjusted-EPOCH as initial therapy: peripheral T-cell lymphoma-not otherwise specified, n = 21; angioimmunoblastic T-cell lymphoma, n = 17; anaplastic lymphoma kinase-positive anaplastic large cell lymphoma, n = 2; and anaplastic lymphoma kinase-negative anaplastic large cell lymphoma, n = 1. The median patient age was 64 years (range: 32-79 years). According to the International Prognostic Index criteria, 51.2% were at high-intermediate or high risk. The overall response rate and complete response rate were 78.0% (95% confidence interval [CI], 62.4-89.4%) and 61.0% (95% CI, 44.5-75.8%), respectively. At the median follow-up time of 24.0 months, the 2-year progression-free survival and overall survival were 53.3% (95% CI, 36.4-67.5%) and 73.2% (95% confidence interval, 56.8-84.1%), respectively. The younger patients (≤ 60 years old) had high response (overall response rate 94.1% and complete response rate 70.6%) and survival (progression-free survival 62.5% and overall survival 82.4%) rates. The most common grade ≥ 3 adverse events were neutropenia (74.5%), anemia (40.8%), thrombocytopenia (22.0%), and febrile neutropenia (9.0%). Dose-adjusted-EPOCH had a high response rate with a tolerable toxicity profile. Our results indicate that dose-adjusted-EPOCH is a reasonable first-line approach for peripheral T-cell lymphoma patients and may improve the outcomes.

Publisher URL: http://doi.org/10.3324/haematol.2017.167742

DOI: 10.3324/haematol.2017.167742

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