[Clinical outcomes of patients with peripheral T-cell lymphoma (PTCL) treated by EPOCH regimen]

Abstract

Background & objectives: The biological behavior of peripheral T-cell lymphoma (PTCL) are different from that of B-cell non-Hodgkin's lymphoma (NHL). It shows low chemosensitivity, high incidence of relapse, poor prognosis, and has no standard chemotherapy regimen. The efficacy of CHOP is poor for PTCL. This study was to evaluate the efficacy and toxicity of EPOCH regimen for PTCL.

Methods: EPOCH regimen(doxorubicin/epirubicin, vincristine, etoposide over 96 hours' infusion with bolus cyclophosphamide,and oral prednisone) was administered to 21 patients with PTCL. According to WHO classification criteria, 21 cases of PTCL concluded 7 peripheral T-cell lymphoma unspecified (PTCL-U), 7 NK/T-cell lymphoma (NK/TCL), 5 anaplastic large cell lymphoma (ALCL), 1 Mycosis fungoides/Sezary syndrome (MF/SS), and 1 subcutaneous panniculitis-like T-cell lymphoma (SPTCL). Among them there were 14 previously untreated patients, 7 pretreated and recurrent patients. Median cycles of EPOCH regimen administered were 3 (ranged from 1 to 7 cycles).

Results: Of 21 patients, 20 were eligible to evaluate treatment efficacy. The response rate (RR) for the whole group was 85% (17/20) with complete remission (CR) rate of 50% (10/20). The RRs of patients with NK/TCL, PTCL-U, and ALCL were 71.4% (5/7), 100.0% (6/6), and 80.0%(4/5); the CR rates were 57.1% (4/7), 50.0% (3/6), and 40.0% (2/5). The RR of patients which haven't been pretreated was 84.6% (11/13), the CR rate was 61.5% (8/13); While the RR of pretreated patients was 85.5% (6/7), the CR rate was 28.5% (2/7). Seventy cycles of chemotherapy were administered to 21 patients. Major toxicity was myelosuppression, the incidences of grade III-IV neutropenia, thrombocytopenia, and anemia were 34.3%, 14.3%, and 7.1%. Other toxicities were mild, no treatment-related mortality occurred.

Conclusion: EPOCH was effective and well tolerant for the patients with PTCL.