Epic as an effective, low toxicity salvage therapy for patients with poor risk lymphoma prior to beam high dose chemotherapy and peripheral blood progenitor cell transplantation

We treated 33 patients with relapsed or refractory non-Hodgkin's lymphoma ( NHL) or Hodgkin's disease (HD) with a combination of etoposide, prednisolon e, ifosfamide and carboplatin (EPIC). After a median of two courses (range 1-5) complete response was achieved in 7 (22%) patients and partial respons e in 12 (37%) patients, an overall response rate of 59%. The regimen was we ll tolerated with myelosuppression being the most common toxicity. There we re no toxic deaths. 25 (78%) patients were able to proceed to high dose the rapy (BEAM) with peripheral blood progenitor cell transplantation either im mediately post EPIC or following further salvage therapy. Most patients mob ilised peripheral blood progenitor cells well and 24 out of 25 patients sub sequently undergoing autologous transplantation had rapid regeneration of c ounts. EPIC is an effective salvage therapy in the majority of patients wit h relapsed or refractory lymphoma and does not appear to be toxic to stem c ells. Although severe, myelosuppression is of short duration and the genera lly low toxicity enables patients to proceed to successful peripheral blood stem cell harvest and transplantation.