Infusional chemotherapy (EPOCH) in patients with refractory or relapsed lymphoma.
Seventeen patients with refractory (7 cases) or relapsed (10 cases) lymphoma were treated with a continuous infusion of etoposide, vincristine, and doxorubicin, in addition to cyclophosphamide (bolus) and prednisone (regimen EPOCH). Six patients (4 with Hodgkin's disease) achieved a complete response (CR) (35%; 95% CI: 14-62%). However, 5 of 6 patients had achieved a CR with their initial therapy. Myelosuppression was the most serious effect (29% of patients with grade IV leukopenia after the first course). There were two treatment-related deaths. Doses were lower than originally reported (median: 68%). Infusional therapy with EPOCH is an active regimen in these heavily pretreated patients, particularly in relapsed Hodgkin's disease. It seems a useful protocol to prove chemosensitivity before bone marrow transplantation. However, the true role of infusional treatment has to be determined in clinical trials.
Carrión
J R
JR
Service of Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
García Arroyo
F R
FR
Salinas
P
P
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004351:Drug Resistance; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011241:Prednisone / Q000008:administration & dosage; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone