Annals of Oncology 15:511-516, 2004
© 2004 European Society for Medical Oncology
Original Paper |
Rituximab–EPOCH, an effective salvage therapy for relapsed, refractory or transformed B-cell lymphomas: results of a phase II study
Received 12 August 2003; revised 9 October 2003; accepted 11 November 2003Background:
Relapsed or refractory diffuse large B-cell and mantle-cell lymphoma have a poor prognosis. The EPOCH regimen and rituximab monotherapy have demonstrated activity as salvage therapies. Because of their non-overlapping toxicity, we evaluated their combination as salvage therapy in a phase II study.
Patients and methods:
Patients with relapsed or refractory CD20-positive large B-cell and mantle-cell lymphoma were offered treatment with rituximab 375 mg/m2 intravenously (i.v.) on day 1, doxorubicin 15 mg/m2 as a continuous i.v. infusion on days 2–4, etoposide 65 mg/m2 as a continuous i.v. infusion on days 2–4, vincristine 0.5 mg as a continuous i.v. infusion on days 2–4, cyclophosphamide 750 mg/m2 i.v. on day 5 and prednisone 60 mg/m2 orally on days 1–14.
Results:
Fifty patients, with a median age of 56 years (range 23–72), entered the study. Twenty-five had primary diffuse large B-cell lymphoma, 18 transformed large B-cell lymphoma and seven mantle-cell lymphoma. The median number of prior chemotherapy regimens was 1.7 (range one to four). The median number of treatment cycles was four (range one to six). Possible treatment-related death occurred in two patients. Objective responses were obtained in 68% of patients (28% complete responses, 40% partial responses). Nineteen patients received consolidating high-dose chemotherapy with autologous stem-cell transplantation. The median follow-up was 33 months. Three patients developed a secondary myelodysplastic syndrome. The median overall survival was 17.9 months; the projected overall survival at 1, 2 and 3 years was 66, 42 and 35%, respectively. The median event-free survival was 11.8 months; the projected event-free survival at 1, 2 and 3 years was 50, 30 and 26%, respectively.
Conclusion:
The rituximab–EPOCH regimen is effective and well tolerated, even in extensively pretreated patients with relapsed or refractory large B-cell lymphoma and mantle-cell lymphoma.
1 University Hospital of Zurich, 2 Triemli Hospital Zurich, 3 Inselspital Bern, 4 Kantonsspital Chur, 5 Kantonsspital Winterthur, Switzerland
Key words: autologous stem-cell transplantation, EPOCH, high-dose chemotherapy, refractory aggressive B-cell non-Hodgkin’s lymphoma, relapsed aggressive B-cell non-Hodgkin’s lymphoma, rituximab, salvage chemotherapy
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Martin, E. Conde, M. Arnan, M. A. Canales, G. Deben, J. M. Sancho, R. Andreu, A. Salar, P. Garcia-Sanchez, L. Vazquez, et al. R-ESHAP as salvage therapy for patients with relapsed or refractory diffuse large B-cell lymphoma: the influence of prior exposure to rituximab on outcome. A GEL/TAMO study Haematologica, December 1, 2008; 93(12): 1829 - 1836. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T El Gnaoui, J Dupuis, K Belhadj, J-P Jais, A Rahmouni, C Copie-Bergman, I Gaillard, M Divine, I Tabah-Fisch, F Reyes, et al. Rituximab, gemcitabine and oxaliplatin: an effective salvage regimen for patients with relapsed or refractory B-cell lymphoma not candidates for high-dose therapy Ann. Onc., August 1, 2007; 18(8): 1363 - 1368. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Freedman Biology and Management of Histologic Transformation of Indolent Lymphoma Hematology, January 1, 2005; 2005(1): 314 - 320. [Abstract] [Full Text] [PDF]
|
|