Efficacy and safety of the modified EPOCH regimen (etoposide, vincristine, doxorubicin, carboplatin, and prednisolone) for adult T-cell leukemia/lymphoma: a multicenter retrospective study

Abstract Background We retrospectively analyzed patients with untreated aggressive adult T-cell leukemia/lymphoma who received the modified EPOCH (mEPOCH) regimen. Patients and Methods Patients received up to six mEPOCH cycles. Etoposide (50 mg/m2/day), doxorubicin (10 mg/m2/day), and vincristine (0.4 mg/day) were each given as a continuous 96-h infusion on days 1–4. Prednisolone (40 mg/m2/day) was given intravenously or orally on days 1–4 and then tapered and stopped on day 7, and carboplatin (dose calculated for each patient individually using Calvert’s formula according to a target under the curve of 3 mg/mL/min) was given as a 2-h intravenous infusion on day 6. Results In 103 patients, overall response rate and complete response rate were 58% and 25%, respectively. With a median follow-up of 8.9 months, the median survival time was 9.8 months (95% confidence interval [CI], 7.2–13.9). Median progression-free survival (PFS) was 4.2 months (95% CI, 3.4–5.7). Patients who completed ≥4 cycles experienced significantly better overall survival (OS) and PFS compared with those who completed Conclusion The mEPOCH regimen is effective with tolerable adverse effects and may be an alternative treatment option for adult T-cell leukemia/lymphoma.