International Journal of Hematology

DOI: 10.1007/s12185-018-2455-x Pages: 167-175

EPOCH regimen as salvage therapy for adult T-cell leukemia–lymphoma

1. Nagasaki University Graduate School of Biomedical Sciences, Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit

2. Nagasaki University Hospital, Department of Hematology

3. Sasebo City General Medical Center, Department of Hematology

4. Japanese Red Cross Nagasaki Genbaku Hospital, Department of Hematology

5. National Hospital Organization Nagasaki Medical Center, Department of Hematology

6. University of the Ryukyus, Laboratory of Hematoimmunology, School of Health Sciences, Faculty of Medicine

Correspondence to:
Yoshitaka Imaizumi
Tel: +81-95-819-7380
Email: y-imaizm@nagasaki-u.ac.jp

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Abstract

Adult T-cell leukemia–lymphoma (ATL) is an intractable hematopoietic malignancy with a very poor prognosis. Although improved responses have been achieved through intensive chemotherapy in newly diagnosed patients with aggressive ATL, most patients suffer from relapse or disease recurrence, and an effective salvage therapy, especially for candidates for allogeneic hematopoietic stem cell transplantation (allo-HSCT), is yet to be established. The efficacy of the EPOCH regimen has been reported for several lymphoid malignancies; however, its efficacy for ATL has not been sufficiently evaluated. Here, we report results of a study of the EPOCH regimen as a salvage therapy for ATL. We retrospectively analyzed patients with relapsed or refractory ATL treated in our institution, with EPOCH as a first salvage therapy. Fourteen patients with a median age of 58 years were analyzed, among whom eight achieved a response, including a complete response in one patient and partial responses in seven. Seven patients underwent allo-HSCT after EPOCH therapy; however, the median overall survival (OS) could not be determined, whereas OS at 2 years after allo-HSCT was estimated to be 85.7%. These results suggest that EPOCH is an option for salvage therapy in patients with ATL, including candidates for allo-HSCT.

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