Evaluating the safety of EPOCH-R therapy for patients with non-Hodgkin’s lymphoma

This study investigated complications associated with reduced-intensity EPOCH-R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, rituximab) therapy for patients with non-Hodgkin’s lymphoma (NHL). This study concluded that this treatment was associated with high rates of drug delivery complications.

For patients with aggressive NHL, reduced-intensity EPOCH-R chemotherapy has become a common treatment option. Compared to other chemoimmunotherapy regimens, EPOCH-R is given using a central venous catheter (CVC). It is also called a central line. This is a long tube that is inserted into a large vein in the chest or upper arm. This delivers the chemotherapy directly into the patient’s bloodstream.

CVCs are associated with some complications, such as the formation of a blood clot inside a large vein. This is called venous thromboembolism (VTE). How often this complication occurs in patients with aggressive NHL undergoing treatment with reduced-intensity EPOCH-R remains under investigation.

This study involved 87 patients with NHL. 43 (49.4%) patients received EPOCH-R. 44 (50.6%) patients received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone).

In the EPOCH-R group, 39.5% of patients experienced at least one catheter-related complication. 35% of patients developed VTE. 3 patients experienced central line-related infections.

In the R-CHOP group, 18% of patients experienced at least one catheter-related complication such as VTE and infection. Of these, 62.5% of cases were severe to life-threatening. 

This study concluded that reduced-intensity EPOCH-R is associated with high rates of central line-associated complications.

This study was retrospective, meaning that it looked back in time to analyze data. Also, the patient population in this study was small. Larger studies are needed to confirm these results.