TY - JOUR
T1 - Dose-adjusted EPOCH with or without rituximab for aggressive lymphoma patients
T2 - real world data
AU - Matsuda, Shinichiro
AU - Suzuki, Ritsuro
AU - Takahashi, Tsutomu
AU - Suehiro, Youko
AU - Tomita, Naoto
AU - Izutsu, Koji
AU - Fukuhara, Noriko
AU - Imaizumi, Yoshitaka
AU - Shimada, Kazuyuki
AU - Nakazato, Tomonori
AU - Yoshida, Isao
AU - Miyazaki, Kana
AU - Yamaguchi, Motoko
AU - Suzumiya, Junji
N1 - Funding Information:
We wish to thank all of the patients and their families, and Ms. Tomita and Ms. Komori for their help with data collection and the writing of the manuscript. This study was supported in part by the Practical Research for Innovative Cancer Control from the Japan Agency for Medical Research and Development (JP18ck0106439, J.S.).
Funding Information:
Dr. Matsuda has nothing to disclose. Dr. Suzuki reports personal fees from Bristol-Meyer Squib, personal fees from Novartis, personal fees from Kyowa-Hakko Kirin, personal fees from Chugai Pharmaceuticals, personal fees from Shionogi, personal fees from Takeda, personal fees from Meiji Seika Pharma, personal fees from MSD, personal fees from Ohtsuka, personal fees from Sawai, personal fees from Celgene, personal fees from Sumitomo Dainippon, personal fees from Eisai Pharmaceuticals, personal fees from Alexion Pharma, personal fees from Sanofi, personal fees from Gilead Sciences, personal fees from Abbvie, personal fees from Jazz Pharma, personal fees from Ono Pharma, personal fees from Janssen Pharmaceuticals, outside the submitted work; Dr. Takahashi reports personal fees from Kyowa Kirin Co., Ltd., personal fees from CELGENE CORPORATION, personal fees from Bristol-Myers Squibb Company, personal fees from Chugai Pharmaceutical Co., Ltd., outside the submitted work; Dr. Suehiro has nothing to disclose. Dr. Tomita has nothing to disclose. Dr. Izutsu reports grants and personal fees from Gilead Sciences, grants from Eisai, grants and personal fees from MSD, grants and personal fees from Takeda, grants and personal fees from Janssen, personal fees from Bristol Myers Squib, personal fees from Dainihon Sumitomo, grants and personal fees from Mundipharma, personal fees from Nihon Mediphysics, grants and personal fees from Chugai, grants and personal fees from Astrazeneca, grants and personal fees from Bayer, grants and personal fees from Ono, grants from Zenyaku, grants and personal fees from Celgene, grants from Solasia, grants from Symbio, grants from Astellas, grants from Astellas Amgen, grants from Daiichi Sankyo, grants and personal fees from Kyowa Kirin, outside the submitted work; Dr. Fukuhara reports grants and personal fees from Chugai pharma, grants and personal fees from Eisai, grants and personal fees from Kyowa Kirin, grants and personal fees from Janssen, personal fees from Mochida, personal fees from Mundi, personal fees from Nippon Shinyaku, grants and personal fees from Ono Pharmacuetical, grants and personal fees from Takeda, personal fees from Zenyaku, grants and personal fees from Celgene, grants and personal fees from Abbvie, grants from Bayer, grants from Soleisia Pharma, personal fees from Stemline Therapeutics, personal fees from HUYA/IQVIA Services Japan, personal fees from Novartis, grants from Gilead Sciences, outside the submitted work; Dr. Imaizumi has nothing to disclose. Dr. Shimada reports personal fees from AstraZeneca, grants and personal fees from Eisai, grants and personal fees from Celgene, grants from Otsuka Pharmaceutical, grants from MSD, personal fees from Takeda Pharmaceutical, personal fees from Janssen Pharmaceutical, personal fees from Bristol-Myers Squibb, grants and personal fees from Chugai Pharmaceutical, grants and personal fees from Kyowa Kirin, personal fees from Nippon Shinyaku, grants and personal fees from Daiichi Sankyo, outside the submitted work; Dr. Nakazato has nothing to disclose. Dr. Yoshida reports personal fees from Mundi pharma, personal fees from Kyowa Kirin, personal fees from Taiho Pharma, personal fees from Celegene, personal fees from Takeda, personal fees from Bristol Myers Squibb, personal fees from Shire japan, personal fees from Mochida Pharma, personal fees from Chugai Pharma, personal fees from MSD, personal fees from Eisai, personal fees from Janssen, personal fees from Ono Pharma, personal fees from Astrazeneca, during the conduct of the study; Dr. Miyazaki reports grants from Astellas Pharma, grants from Kyowa Kirin, grants from Ono Pharmaceutical, grants from Takeda Pharmaceutical, outside the submitted work; Dr. Yamaguchi reports grants from Astellas Pharma, grants from Kyowa Kirin, grants from Ono Pharmaceutical, grants from Takeda Pharmaceutical, outside the submitted work; Dr. Suzumiya reports grants and personal fees from AstraZeneca, personal fees from Abbvie, grants and personal fees from Eisai, grants and personal fees from Celgene, grants and personal fees from Takeda, grants and personal fees from Chugai, personal fees from Bristrol-Myers Squibb, personal fees from Janssen, grants and personal fees from Symbio, grants from Bayer, grants from Yakult, personal fees from MSD, grants and personal fees from Astellas, grants and personal fees from Elli lli, grants and personal fees from Ohtsuka, grants and personal fees from Ono, grants and personal fees from Kyowa Kirin, personal fees from Shire, personal fees from Zenyaku Kogyo, personal fees from Nippon Shinyaku, grants and personal fees from Sumitomo Dainippon, grants and personal fees from Taiho, personal fees from Novartis, personal fees from Bioverative, personal fees from Pfizer, personal fees from Mochida, grants from Japan Blood Products, grants from Shionogi, grants from Meiji Seika Pharma, personal fees from CSL Behring, outside the submitted work.
Publisher Copyright:
© 2020, Japanese Society of Hematology.
PY - 2020/12
Y1 - 2020/12
N2 - CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) −/+ rituximab (R) is the standard chemotherapeutic regimen for aggressive lymphoma, but is insufficient for aggressive lymphoma with adverse prognostic factors. Dose-adjusted (DA)-EPOCH (etoposide, doxorubicin, cyclophosphamide, vincristine, and prednisolone) −/+ R demonstrates excellent efficacy against some aggressive lymphoma. Thus, we conducted a retrospective study to evaluate the feasibility and efficacy of this therapy in clinical practice. We enrolled 149 patients from 17 institutions diagnosed between 2007 and 2015. The median follow-up period for survivors was 27 months (range 0.2–123). The complete response (CR) rate of newly diagnosed patients was 79% (95% CI 68–87%). All patients were hospitalized to receive this therapy and 94% of patients also received granulocyte-colony-stimulating factor support. There were no treatment-related deaths. Febrile neutropenia (FN) and grade 3 or 4 infection occurred in 55% and 28% of patients, respectively. There were no significant differences in FN or infection between young (≤ 65 years) and elderly patients (> 65 years). In newly diagnosed diffuse large B-cell lymphoma-not otherwise specified patients (n = 46), the CR rate was 80% (95% CI 64–91%) and the 2-year OS rate was 81% (95% CI 66–90%). In the present study, DA-EPOCH −/+ R exhibited excellent efficacy and feasibility for aggressive lymphoma.
AB - CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) −/+ rituximab (R) is the standard chemotherapeutic regimen for aggressive lymphoma, but is insufficient for aggressive lymphoma with adverse prognostic factors. Dose-adjusted (DA)-EPOCH (etoposide, doxorubicin, cyclophosphamide, vincristine, and prednisolone) −/+ R demonstrates excellent efficacy against some aggressive lymphoma. Thus, we conducted a retrospective study to evaluate the feasibility and efficacy of this therapy in clinical practice. We enrolled 149 patients from 17 institutions diagnosed between 2007 and 2015. The median follow-up period for survivors was 27 months (range 0.2–123). The complete response (CR) rate of newly diagnosed patients was 79% (95% CI 68–87%). All patients were hospitalized to receive this therapy and 94% of patients also received granulocyte-colony-stimulating factor support. There were no treatment-related deaths. Febrile neutropenia (FN) and grade 3 or 4 infection occurred in 55% and 28% of patients, respectively. There were no significant differences in FN or infection between young (≤ 65 years) and elderly patients (> 65 years). In newly diagnosed diffuse large B-cell lymphoma-not otherwise specified patients (n = 46), the CR rate was 80% (95% CI 64–91%) and the 2-year OS rate was 81% (95% CI 66–90%). In the present study, DA-EPOCH −/+ R exhibited excellent efficacy and feasibility for aggressive lymphoma.
KW - DA-EPOCH
KW - DLBCL
KW - Lymphoma
UR - http://www.scopus.com/inward/record.url?scp=85090307104&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85090307104&partnerID=8YFLogxK
U2 - 10.1007/s12185-020-02984-w
DO - 10.1007/s12185-020-02984-w
M3 - Article
C2 - 32880824
AN - SCOPUS:85090307104
VL - 112
SP - 807
EP - 816
JO - International Journal of Hematology
JF - International Journal of Hematology
SN - 0925-5710
IS - 6
ER -