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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

Authors
 Young-Woong Won  ;  Hyewon Lee  ;  Hyeon-Seok Eom  ;  Jin Seok Kim  ;  Cheolwon Suh  ;  Dok Hyun Yoon  ;  Jung Yong Hong  ;  Hye Jin Kang  ;  Jae Hoon Lee  ;  Won Seog Kim  ;  Seok Jin Kim  ;  Won-Sik Lee  ;  Myung Hee Chang  ;  Young Rok Do  ;  Jun Ho Yi  ;  Inho Kim  ;  Jong-Ho Won  ;  Kyoungha Kim  ;  Sung Yong Oh  ;  Jae-Cheol Jo 
Citation
 ANNALS OF HEMATOLOGY, Vol.99(2) : 255-264, 2020-02 
Journal Title
ANNALS OF HEMATOLOGY
ISSN
 0939-5555 
Issue Date
2020-02
MeSH
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols / administration & dosage* ; Antineoplastic Combined Chemotherapy Protocols / adverse effects ; C-Reactive Protein / metabolism ; Cytarabine / administration & dosage ; Cytarabine / adverse effects ; Disease-Free Survival ; Etoposide / administration & dosage ; Etoposide / adverse effects ; Female ; Hodgkin Disease* / blood ; Hodgkin Disease* / drug therapy ; Hodgkin Disease* / mortality ; Humans ; Male ; Methylprednisolone / administration & dosage ; Methylprednisolone / adverse effects ; Middle Aged ; Neoplasm Proteins / blood* ; Oxaliplatin / administration & dosage ; Oxaliplatin / adverse effects ; Recurrence ; Survival Rate ; Time Factors ; Tumor Necrosis Factor-alpha / blood ; Vascular Endothelial Growth Factor A / blood
Keywords
Etoposide ; Methylprednisolone ; Cytarabine ; Oxaliplatin ; Hodgkin'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/m(2) on days 1 to 4, i.v. methylprednisolone 500 mg on days 1 to 5, i.v. cytarabine 2 g/m(2) on day 5, and i.v. oxaliplatin 130 mg/m(2) 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-alpha (TNF-alpha), 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-alpha and CRP were significantly associated with poorer overall survival (p = 0.00005 for TNF-alpha, p = 0.0004 for CRP, respectively). The ESHAOx regimen exhibited antitumor activity and an acceptable safety profile in patients with refractory or relapsed HL.
Full Text
https://link.springer.com/article/10.1007/s00277-019-03891-9
DOI
10.1007/s00277-019-03891-9
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Lee, Hye Won(이혜원) ORCID logo https://orcid.org/0000-0002-3552-3560
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190235
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