R-EPOCH chemotherapy administration relies on infusions at variable concentrations over a longer period of timefour days.
What Is DA-R-EPOCH?
A 96-hour continuous infusion regimen was developed, whereby DA-R-EPOCH is administered every 21 days.
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The World Health Organization (WHO) classifies DLBCL into four major categories.
The largest categoryDLBCL not otherwise specifiedcan be further subdivided into three subtypes based on the cell of origin.
In addition, a related key in of aggressive lymphoma is called “double hit” lymphoma.
It has specific genetic abnormalities that may affect outcomes.
DA-R-EPOCH showed increased toxicity, but this was expected based on the higher dose intensity.
Tumors with high proliferation are expected to have high expression of Ki-67.
The R-EPOCH chemotherapy regimen was given as first-line treatment in DLBCL people with high Ki-67 expression.
It was compared to the treatment efficacy of R-EPOCH and R-CHOP therapy in this Ki-67 subgroup.
The DA-EPOCH-R regimen resulted in significantly higher rates of complete remission than the other intensive regimens.
It is clinically and biologically related to nodular sclerosing Hodgkin lymphoma, which also arises from thymic B-cells.
PMBL is aggressive and develops into amediastinal mass.
Most people have mutations in the BCL-6 gene.
Primary mediastinal lymphoma (PMBL) is a relatively rare lymphoma with not a lot of clinical study data.
DA-EPOCH-R uses infused doses of the drugs etoposide, doxorubicin, and cyclophosphamide that are adjusted for optimal effect.
It found that all but two people achieved a complete remission with DA-EPOCH-R therapy.
None of the people with a complete remission developed a recurrent lymphoma in later monitoring.
The two others received radiation and had also not had their tumors recur.
There was no evidence of other diseases developing later on or cardiac toxic effects.
A broad study of adults with PMBL compared overall survival in people treated with these regimens.
They included 132 from 11 treatment centers, 56 of them receiving R-CHOP and 76 receiving DA-R-EPOCH.
At two years, 89% of R-CHOP people and 91% of DA-R-EPOCH people remained alive.
R-EPOCH for Burkitt Lymphoma
Burkitt lymphoma is more common in equatorial Africa than in Western countries.
Burkitt is a disease that occurs frequently in immune-suppressedpeople living with AIDS.
They show promise in treating certain people with DLBCL and other malignancies.
If you fall into these subsets, discuss the option with your healthcare provider.
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