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Activity of Infusional Etoposide, Vincristine, and Doxorubicin with Bolus Cyclophosphamide (EPOCH) in Relapsed Hodgkin's Disease

Baylor-Sammons Cancer Center, Dallas, Texas, USA; Texas Oncology, P.A., Dallas, Texas, USA

Correspondence: Vinay K. Jain, M.D., Baylor-Sammons Cancer Center, Directory, Lymphoma Biology Section, 3500 Gaston Avenue, Dallas, Texas 75246, USA. Telephone 214-820-8439; Fax: 214-820-8844; e-mail: vinayj{at}baylordallas.edu

Introduction. A phase II study of EPOCH chemotherapy in relapsed Hodgkin's disease was performed in 14 patients in a multicenter community setting.

Patients and Methods. A total of 14 patients (9 males and 5 females) were included in the study. Ages ranged from 21-72 with a median age of 33. Eleven out of 14 patients had advanced (stage III or IV) disease, but all patients had good performance status. All 14 patients had received prior chemotherapy with ABVD, MOPP, or MOPP/ABVD hybrid.

Results. A total of 57 cycles of EPOCH were administered during this trial. Patients received a median of four cycles of chemotherapy. An overall response rate of 86% was seen among the 14 patients with one patient achieving a complete response. Following EPOCH chemotherapy, 7 of 12 patients who responded underwent high-dose chemotherapy with stem cell support. Six out of 14 patients are currently alive, and three had no evidence of disease at the time of last follow-up. Toxicity with EPOCH chemotherapy consisted mainly of myelosuppression, and most patients were managed on an outpatient basis.

Conclusion. This multicenter community study confirms the activity of EPOCH chemotherapy in the treatment of patients with relapsed Hodgkin's disease.

Key Words. EPOCH • Hodgkin's • Relapse • Chemotherapy