Dose adjusted R-EPOCH and other etoposide-containing regimens in first-line treatment of diffuse large B-cell lymphoma

Etoposide is a well-known cytotoxic agent effective in the treatment of B-large cell lymphoma (B-LCL). Currently, there no consensus regarding place etoposide-containing regimens (R-CHOEP, R-ACVBP and DA-R-EPOCH) front-line B-LCL. This paper summarizes published data our own experience activity toxicity these regimens, especially DA-R-EPOCH. Most non-randomized, real-life retrospective studies suggest that, compared to R-CHOP, DA-R-EPOCH, similarly other has superior antitumor efficacy but also more toxic. The most important severe side-effects are hematological infectious, making regimen unfeasible unfit patients. However, fit patients with high-risk features, progression-free survival rates seem improved by 15–20% R-CHOP. In series [age-adjusted International Prognostic Index (aaIPI) 2–3] [Eastern Cooperative Oncology Group (ECOG) performance status 0–2]) B-LCL older than 60 treated PFS at 2 years was 70%, while it 53% comparable historical cohort DA-R-EPOCH resulted infectious toxicity, treatment-related mortality. opinion, should be considered newly diagnosed, fit, who 60, provided that adequate outpatient supervision, supportive care, prompt hospital admittance case neutropenic fever or toxicities.