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A phase II study of etoposide, methylprednisolone, high-dose cytarabine, and oxaliplatin (ESHAOx) for patients with refractory or relapsed Hodgkin's lymphoma

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Author(s)
Young-Woong WonHyewon LeeHyeon-Seok EomJin Seok KimCheolwon SuhDok Hyun YoonJung Yong HongHye Jin KangJae Hoon LeeWon Seog KimSeok Jin KimWon-Sik LeeMyung Hee ChangYoung Rok DoJun Ho YiInho KimJong-Ho WonKyoungha KimSung Yong OhJae-Cheol Jo
Publication Year
2020
Keyword
EtoposideMethylprednisoloneCytarabineOxaliplatinHodgkin’s lymphoma
Abstract
We assessed the efficacy and toxicity of etoposide, methylprednisolone, high-dose cytarabine, and oxaliplatin (ESHAOx) combination chemotherapy in patients with refractory or relapsed Hodgkin’s lymphoma (HL). This was an open-label, non-randomized, multi-center phase II study. The ESHAOx regimen consisted of intravenous (i.v.) etoposide 40 mg/m2 on days 1 to 4, i.v. methylprednisolone 500 mg on days 1 to 5, i.v. cytarabine 2 g/m2 on day 5, and i.v. oxaliplatin 130 mg/m2 on day 1. Cycles (up to six) were repeated every 3 weeks. In an effort to identify prognostic markers, the serum levels of cytokines including tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and vascular endothelial growth factor (VEGF) were measured at the time of study entry. A total of 37 patients were enrolled, and 36 were available for evaluation of tumor response. The overall response rate was 72.2% (26/36) (complete response, 33.3% [12/36]; partial response, 38.9% [14/36]). The median time to progression was 34.9 months (95% confidence interval, 23.1–46.7 months). The most common grade 3 or 4 hematological adverse events were neutropenia (16/37, 43.2%), followed by thrombocytopenia (10/37, 27.0%). Grade 3 or 4 non-hematological adverse events were nausea (3/37, 8.1%), anorexia (2/37, 5.4%), mucositis (1/37, 2.7%), and skin rash (1/37, 2.7%). There were no treatment-related deaths. High levels of TNF-α and CRP were significantly associated with poorer overall survival (p = 0.00005 for TNF-α, p = 0.0004 for CRP, respectively). The ESHAOx regimen exhibited antitumor activity and an acceptable safety profile in patients with refractory or relapsed HL.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine (의과대학)
Citation
Annals of Hematology, Vol.99(null) : 255-264, 2020
Type
Article
ISSN
1432-0584
DOI
10.1007/s00277-019-03891-9
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/42722
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