INFUSIONAL CHEMOTHERAPY (EPOCH) IN PATIENTS WITH REFRACTORY OR RELAPSED LYMPHOMA

Seventeen patients with refractory (7 cases) or relapsed (10 cases) ly mphoma were treated with a continuous infusion of etoposide, vincristi ne, and doxorubicin, in addition to cyclophosphamide (bolus) and predn isone (regimen EPOCH). Six patients (4 with Hodgkin's disease) achieve d a complete response (CR) (35%; 95% CI: 14-62%). However, 5 of 6 pati ents had achieved a CR with their initial therapy. Myelosuppression wa s the most serious effect (29% of patients with grade IV leukopenia af ter the first course). There were two treatment-related deaths. Doses were lower than originally reported (median: 68%). Infusional therapy with EPOCH is an active regimen in these heavily pretreated patients, particularly in relapsed Hodgkin's disease. It seems a useful protocol to prove chemosensitivity before bone marrow transplantation. However , the true role of infusional treatment has to be determined in clinic al trials.