CHOEP-21 Chemotherapy for Newly Diagnosed
Nodal Peripheral T-Cell Lymphomas (PTCLs) in
Maharaj Nakorn Chiang Mai Hospital
Ekarat Rattarittamrong MD*,
Lalita Norasetthada MD*, Adisak Tantiworawit MD*,
Chatree Chai-Adisaksopha MD*, Weerasak Nawarawong MD*
Affiliation :
* Division of Hematology, Department of Internal Medicine, Faculty of Medicine,
Chiang Mai University, Chiang Mai, Thailand
Objective : To determine the effectiveness and tolerability of the combination of chemotherapy with cyclophosphamide,
doxorubicin, vincristine, and prednisolone (CHOP) with the addition of etoposide (CHOEP-21) for newly diagnosed nodal
peripheral T-cell lymphomas (PTCLs).
Material and Method: Between January 2009 and October 2011, patients aged 18 to 60 years with newly diagnosed nodal
PTCLs at the Maharaj Nakorn Chiang Mai Hospital were enrolled to receive CHOEP-21 every three weeks for eight cycles.
G-CSF prophylaxis was given to all patients.
Results : Twenty-four patients were enrolled. Twenty of them were male with a median age of 49 years. The majority of
patients (66.7%) had PTCL, not otherwise specified (PTCL, NOS), and 95.8% of the patients were in stage III or IV. The
overall response rate was 58% with 42% having complete response. The response rates were better among patients with
ALK-negative anaplastic large cell lymphoma (ALCL; 100%) and angioimmunoblastic T-cell lymphoma (AITL; 85%) than
those with PTCL, NOS (44%). With a median follow-up of 21 months, the patients had an estimated 2-year event-free
survival, and an overall survival rate of 37.6% and 54.4%, respectively. The most common adverse effects were infection
and hematologic toxicities that was manageable.
Conclusion : Although CHOEP-21 induced favorable responses in patients with ALK-negative ALCL and AITL, the responses
were not durable and further therapy is mandated in management of patients with nodal PTCL.
Keywords : T-cell lymphomas, CHOEP-21 chemotherapy
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