Dose-adjusted EPOCH with or without rituximab for aggressive lymphoma patients: real world data

Shinichiro Matsuda, Ritsuro Suzuki, Tsutomu Takahashi, Youko Suehiro, Naoto Tomita, Koji Izutsu, Noriko Fukuhara, Yoshitaka Imaizumi, Kazuyuki Shimada, Tomonori Nakazato, Isao Yoshida, Kana Miyazaki, Motoko Yamaguchi, Junji Suzumiya

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)807-816
Number of pages10
JournalInternational Journal of Hematology
Issue number6
Publication statusPublished - 2020 Dec


  • Lymphoma


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