title: EPIC: an effective low toxicity regimen for relapsing lymphoma.
abstract: We have treated 40 patients was relapsed or resistant lymphoma with the combination of Etoposide, Prednisolone, Ifosfamide and Cisplatin (EPIC). Complete response was obtained in 11 patients (28%) with an overall response of 58%. The presence of bulky disease (P < 0.005), elevated LDH serum levels (P < 0.005), response to prior chemotherapy (P < 0.01) and B symptoms (P < 0.005) were significantly associated with response. However on multivariate analysis only the presence of bulky disease and of B symptoms were independent adverse factors for response and for survival. The regimen was well tolerated with myelosuppression being the most common toxicity. Leucopenia < or 1,000 microliters-1 and thrombocytopenia < or = 25,000 microliters-1 developed in 27% and 4% of cycles respectively. There were no treatment related deaths. The EPIC regimen has equivalent activity to other reported cisplatin based regimens used in the treatment of recurrent lymphoma, but is associated with lower treatment related morbidity and mortality.
authors.affiliation: Lymphoma Unit, Royal Marsden Hospital, Sutton, Surrey, London, UK.
authors.forename: T
authors.initials: T
authors.lastname: Hickish
authors.forename: A
authors.initials: A
authors.lastname: Roldan
authors.forename: D
authors.initials: D
authors.lastname: Cunningham
authors.forename: J
authors.initials: J
authors.lastname: Mansi
authors.forename: S
authors.initials: S
authors.lastname: Ashley
authors.forename: V
authors.initials: V
authors.lastname: Nicolson
authors.forename: M E
authors.initials: ME
authors.lastname: Gore
authors.forename: D
authors.initials: D
authors.lastname: Catovsky
authors.forename: I E
authors.initials: IE
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001855:Bone Marrow Diseases / Q000139:chemically induced; D002945:Cisplatin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage
chemical_list: D005047:Etoposide; D011239:Prednisolone; D002945:Cisplatin; D007069:Ifosfamide