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Efficacy and Safety of Rituximab plus Modified EPOCH (Etoposide, Vincristine, Doxorubicin, Carboplatin, and Prednisolone) for Transplant-ineligible Relapsed/Refractory Diffuse Large B-cell Lymphoma
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- Fujioka Eriko
- Department of Hematology, Iizuka Hospital, Japan
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- Kiyasu Junichi
- Department of Hematology, Iizuka Hospital, Japan Department of Pathology, Kurume University, Japan
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- Choi Ilseung
- Department of Hematology and Cell Therapy, National Hospital Organization Kyushu Cancer Center, Japan
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- Yagi Yu
- Department of Hematology, Iizuka Hospital, Japan
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- Sawabe Taro
- Department of Hematology, Iizuka Hospital, Japan
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- Oyama Makoto
- Department of Hematology, Iizuka Hospital, Japan
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- Hoashi Kosuke
- Department of Hematology, Iizuka Hospital, Japan
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- Tsuda Mariko
- Department of Hematology, Iizuka Hospital, Japan
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- Takamatsu Akiko
- Department of Hematology, Iizuka Hospital, Japan
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- Haji Shojiro
- Department of Hematology, Iizuka Hospital, Japan Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Japan
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- Yufu Yuji
- Department of Hematology, Iizuka Hospital, Japan
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- Suehiro Youko
- Department of Hematology and Cell Therapy, National Hospital Organization Kyushu Cancer Center, Japan
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- Shiratsuchi Motoaki
- Department of Hematology, Iizuka Hospital, Japan
Description
<p>Objective Despite the recent development of various novel therapeutic approaches for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL), optimal management of patients with R/R DLBCL who are elderly and/or unfit has not yet been established. </p><p>Methods and Patients We retrospectively analyzed the efficacy and safety of the R-mEPOCH regimen comprising rituximab, etoposide, vincristine, doxorubicin, carboplatin, and prednisolone in transplant-ineligible patients with R/R DLBCL. </p><p>Results In total, 22 patients were included in this study. The median patient age was 75 years old. The median number of prior lines of therapy was one (range, 1-5). The overall response rate was 68%, with 45% achieving complete response (CR) or unconfirmed CR and 23% achieving partial response. With a median follow-up of 27.8 months, the median progression-free survival and overall survival (OS) were 17.1 and 27.4 months, respectively. The 2- and 5-year OS rates were 50% and 28%, respectively. The most common grade ≥3 adverse events were neutropenia (n=18 [82%]), febrile neutropenia (n=16 [73%]), anemia (n=12 [55%]), and thrombocytopenia (n=8 [36%]). The median total lifetime cumulative dose of anthracyclines was 281 mg/m2 (range, 69-536 mg/m2) in doxorubicin equivalents. One case of grade 1 bradycardia occurred, leading to the discontinuation of R-mEPOCH. No other cardiac adverse events of grade ≥3 and/or discontinuation of treatment were observed. </p><p>Conclusion Our study suggests that the R-mEPOCH regimen may be an effective and tolerable salvage regimen for transplant-ineligible R/R DLBCL patients. </p>
Journal
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- Internal Medicine
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Internal Medicine advpub (0), 2025
The Japanese Society of Internal Medicine
