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. 2021 Feb 2;12(7):2059-2064.
doi: 10.7150/jca.52958. eCollection 2021.

R-split-EPOCH plus high dose methotrexate in untreated diffuse large B cell lymphoma with MYC rearrangement or double expression of MYC and BCL-2

Peng Sun  1   2 , Yu Wang  1   2 , Cui Chen  3 , Hang Yang  1   2 , Man Nie  1   2 , Xiao-Qing Sun  1   2 , Xiao-Hua He  1   2 , Wen-Qi Jiang  1   2 , Zhi-Ming Li  1   2
Affiliations

R-split-EPOCH plus high dose methotrexate in untreated diffuse large B cell lymphoma with MYC rearrangement or double expression of MYC and BCL-2

Peng Sun et al. J Cancer. .

Abstract

Purpose: Diffuse large B cell lymphoma (DLBCL) with MYC rearrangement or double expression of MYC and BCL-2 (DE DLBCL) has a relatively poor prognosis and does not respond well to standard R-CHOP. In the current study, we aimed to investigate the efficacy and safety of R-split-EPOCH plus high dose methotrexate (HD-MTX) in the particular patient population. Methods: A total of 28 patients diagnosed with DE DLBCL or DLBCL with MYC rearrangement between January 2015 and December 2018 were included and retrospectively analyzed. All the participants underwent R-split-EPOCH plus HD-MTX as introduction therapy, with split infusion of etoposide, doxorubicin, and vincristine for 48 hours on D1-2 and D10-11, respectively. Results: The overall objective response (ORR) rate was 100%, with 24 (85.7%) complete response (CR) and 4 (14.3%) partial response (PR). The CR rate was 76.9% and 93.3% for DLBCL patients with MYC rearrangement and DE DLBCL patients, respectively. The 1- and 3-year PFS rate was 100% and 74.9%, respectively. The 1- and 3-year OS rate was 100% and 92.9%, respectively. Grade 3/4 non-hematological toxicity and grade 3/4 hematological toxicity occurred in 50% and 85.7% of patients, respectively. No treatment-related death was reported. Conclusions: R-split-EPOCH plus HD-MTX regimen is an effective and feasible treatment option for DE DLBCL and DLBCL with MYC rearrangement.

Keywords: MYC; R-split-EPOCH; diffuse large B cell lymphoma (DLBCL); double expression; high dose methotrexate (HD-MTX).

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Kaplan-Meier curves for progression-free survival (PFS).
Figure 2
Figure 2
Kaplan-Meier curves for overall survival (OS).
See this image and copyright information in PMC

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