EPIC - AN EFFECTIVE LOW TOXICITY REGIMEN FOR RELAPSING LYMPHOMA

We have treated 40 patients was relapsed or resistant lymphoma with th e combination of Etoposide, Prednisolone, Ifosfamide and Cisplatin (EP IC). Complete response was obtained in 11 patients (28%) with an overa ll response of 58%. The presence of bulky disease (P<0.005), elevated LDH serum levels (P<0.005), response to prior chemotherapy (P<0.01) an d B symptoms (P<0.05) were significantly associated with response. How ever on multivariate analysis only the presence of bulky disease and o f B symptoms were independent adverse factors for response and for sur vival. The regimen was well tolerated with myelosuppression being the most common toxicity. Leucopenia less-than-or-equal-to 1,000 mul-1 and thrombocytopenia less-than-or-equal-to 25,000 mul-1 developed in 27% and 4% of cycles respectively. There were no treatment related deaths. The EPIC regimen has equivalent activity to other reported cisplatin based regimens used in the treatment of recurrent lymphoma, but is ass ociated with lower treatment related morbidity and mortality.