J Korean Med Sci.  2004 Dec;19(6):820-825. 10.3346/jkms.2004.19.6.820.

Phase II Study of Cyclophosphamide, Epirubicin, Vincristine, Prednisone, and Etoposide (CEOP-E) for Aggressive Non-Hodgkin 's Lymphoma

• Kim JG
• Sohn SK
• Kim DH
• Baek JH
• Park TI
• Lee KB

• KMID: 1778563
• DOI: http://doi.org/10.3346/jkms.2004.19.6.820

Abstract

The main objectives of the current study were to evaluate the efficacy and safety of a CEOP-E regimen for patients with aggressive non-Hodgkin's lymphoma (NHL). Fifty-one consecutive patients with newly diagnosed aggressive NHL were enrolled in the study. Median age of patients was 57 (range, 18-75) yr old, and male to female ratio was 1.32:1. Diffuse large B cell lymphoma (68.8%) was the most common histological subtype. Thirty patients (58.8%) had Ann Arbor stage III or IV diseases at diagnosis. One course of chemotherapy consisted of an intravenous combination of cyclophosphamide 750 mg/m2, epirubicin 50 mg/m2, vincristine 2 mg, etoposide 80 mg/m 2 on day 1 and oral administration of 100 mg prednisone on days 1 to 5 (CEOP-E). A complete response or unconfirmed complete response was achieved in 31 (63.3%) out of 49 evaluated patients. With a median follow-up of 16.3 months, 26 events including relapse and death were observed. The estimated 2-yr survival rate for all patients and disease free survival rate for patients achieving complete re-sponse was 58.9% and 57.1%, respectively. Episodes of febrile neutropenia occurred in 5 (10.2%) patients. Transient episodes of ECG abnormality (1st degree AV block) were observed in 2 patients. Accordingly, the CEOP-E regimen produced comparable results to those of other regimens, including CHOP, in terms of the response rate and overall survival. The current regimen seemed to minimize the cardiac toxicity due to an accumulated dose of anthracycline in the treatment of aggressive NHL.

Keyword

Lymphoma, Non-Hodgkin; Drug Therapy; CEOP-E Regimen; Cyclophosphamide; Epirubicin, Vincristine; Prednisone; Etoposide

MeSH Terms

Adolescent
Adult
Aged
Antineoplastic Agents/administration & dosage
Antineoplastic Combined Chemotherapy Protocols/*administration & dosage
Cyclophosphamide/*administration & dosage
Epirubicin/*administration & dosage
Etoposide/*administration & dosage
Female
Humans
Lymphoma, Non-Hodgkin/*drug therapy/*mortality
Male
Middle Aged
Prednisone/*administration & dosage
Risk Assessment/*methods
Risk Factors
Survival Analysis
Treatment Outcome
Vincristine/*administration & dosage

Figure

• 

  Fig. 1 Survival curves. (A) Estimated 2-yr overall survival rate and (B) DFS rate for all patients was 58.9% and 43.8%, respectively. (C) Disease-free survival rate for patients that achieved complete response was 57.1%.

• 

  Fig. 2 Survival curves according to International Prognostic Index. Estimated 2-yr PFS rate for low, low-intermediate, high-intermediate, and high risk groups was 59.9%, 51.5%, 16.7%, and 0%, respectively (p=0.0043).

• 

  Fig. 3 Survival curves according to immunophenotype. Estimated two-year survival rate was statistically not different between for patients with B cell NHL and for patients with T cell NHL (66.0% vs. 58.7%, p=0.1840).

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