నైరూప్య

The anglia regional experience of using PEP-C as palliative chemotherapy in relapsed refractory lymphoma: A multicentre retrospective cohort study.

Anna Santarsieri*, Annabel M Follows, Simon J Bulley, James Russell, Benjamin J Uttenthal, George A Follows, Isabel C Lentell, Andrew Hodson, Oliver Firth, Shalal Sadullah, Mamatha Karanth, Sandra Young Min, Alexis Fowler, Brendan O'Sullivan

PEP-C (Prednisolone, Etoposide, Procarbazine, and Cyclophosphamide) is an orally administered daily chemotherapy regimen used with palliative intent in relapsed refractory lymphoma. To our knowledge no data on PEP-C has been reported since the original group described the regimen. Here we present a multicentre retrospective cohort reporting our use of PEP-C in 92 patients over an eight-year period. We find that even heavily pretreated lymphoma can respond to PEP-C, particularly low grade lymphoma (including mantle cell) and lymphoma that was sensitive to the previous line of systemic therapy (chemosensitive). These characteristics may help in the selection of patients likely to derive benefit. The median overall survival of patients with chemosensitive lymphoma treated with PEP-C is 217 days. Within the limitations of a retrospective cohort we find that PEP-C is well tolerated: The most common toxicity leading to discontinuation is marrow suppression. We suggest that PEP-C should be considered for patients with relapsed refractory lymphoma in two settings: Firstly, where there is no licensed alternative; and secondly, where the licensed alternative is an intravenous drug and the burden of frequent hospital visits for intravenous drug administration would be too great.