Cancer Chemotherapy and Pharmacology

, Volume 83, Issue 3, pp 443–449 | Cite as

A retrospective study of the CHOP, CHOPE, and CHOPE/G regimens as the first-line treatment of peripheral T-cell lymphomas

  • Xuyan Liu
  • Mingzi Yang
  • Meng Wu
  • Wen Zheng
  • Yan Xie
  • Jun Zhu
  • Yuqin Song
  • Weiping LiuEmail author
Original Article



The standard treatment for peripheral T-cell lymphomas (PTCLs) is undetermined. We designed a CHOPE/G regimen (cyclophosphamide, pirarubicin, vincristine, prednisolone, and etoposide alternating with a gemcitabine-based regimen) as the first-line treatment of PTCLs and compared with CHOP (cyclophosphamide, pirarubicin, vincristine, and prednisolone) and CHOPE (CHOP plus etoposide) regimen to evaluate the optimal chemotherapy regimen.


116 previously untreated PTCL patients received CHOP (N = 46), CHOPE (N = 46), or CHOPE/G (N = 24) regimen at Peking University Cancer Hospital from 2009 to 2017 and were retrospectively analyzed.


The overall response rates (ORRs) of the CHOP, CHOPE, and CHOPE/G groups were 82.6%, 76.1%, and 75.0% (p = 0.673), with complete response (CR) rates of 32.6%, 56.5%, and 45.7% (p = 0.063), respectively. Within a median follow-up time of 35.5 months, the 3-year overall survival (OS) rates of the CHOP, CHOPE, and CHOPE/G groups were 37.0%, 47.0%, and 56.3% (p = 0.107), and the 3-year progression-free survival (PFS) rates were 19.9%, 29.9%, and 5.3% (p = 0.093), respectively. Compared with the CHOP regimen alone, CHOPE had a significantly higher CR rate (p = 0.021) with more favorable OS (p = 0.046). The CHOPE/G regimen did not improve the ORR, CR rate, or OS compared with either the CHOP or CHOPE, with a significantly poorer PFS compared with the CHOPE regimen (p = 0.029). Anemia and thrombocytopenia occurred most frequently in the CHOPE/G group (anemia 83.3%, p = 0.035; thrombocytopenia 50%, p = 0.015).


Compared with CHOP alone, CHOPE regimen improved the efficacy and survival; while the addition of gemcitabine in the front-line therapy resulted in more adverse events without benefit of survival.


Peripheral T-cell lymphomas Chemotherapy CHOP Etoposide Gemcitabine 



This study was funded by National Nature Science Foundation of China (Grant number 81470368 and Grant number 81670187), Beijing Natural Science Foundation (Grant number 7172047), Capital’s Funds for Health Improvement and Research (Grant number 2018-1-2151), Beijing Municipal Administration of Hospitals’ Ascent Plan (Grant number DFL20151001), and Beijing Medical and Health Foundation (Grant number 2221-16-157). We thank M.S. Lan Mi for statistical method supporting.


This study was funded by National Nature Science Foundation of China (Grant number 81470368 and grant number 81670187), Beijing Natural Science Foundation (Grant number 7172047), Capital’s Funds for Health Improvement and Research (Grant number 2018-1-2151), Beijing Municipal Administration of Hospitals’ Ascent Plan (Grant number DFL20151001), and Beijing Medical and Health Foundation (Grant number 2221-16-157).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Shankland KR, Armitage JO, Hancock BW (2012) Non-Hodgkin lymphoma. Lancet 380(9844):848–857. CrossRefPubMedGoogle Scholar
  2. 2.
    Ascani S, Zinzani PL, Gherlinzoni F et al (1997) Peripheral T-cell lymphomas. Clinico-pathologic study of 168 cases diagnosed according to the R.E.A.L. classification. Ann Oncol 8(6):583–592. CrossRefPubMedGoogle Scholar
  3. 3.
    Morton LM, Wang SS, Devesa SS et al (2006) Lymphoma incidence patterns by WHO subtype in the United States, 1992–2001. Blood 107(1):265–276. CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Chihara D, Ito H, Matsuda T et al (2014) Differences in incidence and trends of haematological malignancies in Japan and the United States. Br J Haematol 164(4):536–545. CrossRefPubMedGoogle Scholar
  5. 5.
    Park S, Ko YH (2014) Peripheral T cell lymphoma in Asia. Int J Hematol 99(3):227–239. CrossRefPubMedGoogle Scholar
  6. 6.
    Swerdlow SH, Campo E, Pileri SA et al (2016) The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 127(20):2375–2390. CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Vose J, Armitage J, Weisenburger D (2008) International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. J Clin Oncol 26(25):4124–4130. CrossRefPubMedGoogle Scholar
  8. 8.
    National Comprehensive Cancer Network (2018) Lymphomas T-Cell (Version 5) Accessed 13 Aug 2018
  9. 9.
    Ellin F, Landstrom J, Jerkeman M et al (2014) Real-world data on prognostic factors and treatment in peripheral T-cell lymphomas: a study from the Swedish Lymphoma Registry. Blood 124(10):1570–1577. CrossRefPubMedGoogle Scholar
  10. 10.
    Schmitz N, Trümper L, Ziepert M et al (2010) Treatment and prognosis of mature T-cell and NK-cell lymphoma: an analysis of patients with T-cell lymphoma treated in studies of the German high-grade non-Hodgkin Lymphoma Study Group. Blood 116(18):3418–3425. CrossRefPubMedGoogle Scholar
  11. 11.
    Nickelsen M, Ziepert M, Zeynalova S et al (2009) High-dose CHOP plus etoposide (MegaCHOEP) in T-cell lymphoma: a comparative analysis of patients treated within trials of the German high-grade non-Hodgkin Lymphoma Study Group (DSHNHL). Ann Oncol 20(12):1977–1984. CrossRefPubMedGoogle Scholar
  12. 12.
    Escalón MP, Liu NS, Yang Y et al (2005) Prognostic factors and treatment of patients with T-cell non-Hodgkin lymphoma: the M. D. Anderson Cancer Center experience. Cancer 103:2091–2098. CrossRefPubMedGoogle Scholar
  13. 13.
    Dunleavy K, Pittaluga S, Shovlin M et al (2016) Phase II trial of dose adjusted EPOCH in untreated systemic anaplastic large cell lymphoma. Haematologica 101:e27–e29. CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Zinzani PL, Venturini F, Stefoni V et al (2010) Gemcitabine as single agent in pretreated T cell lymphoma patients: evaluation of the long-term outcome. Ann Oncol 21(4):860–863. CrossRefPubMedGoogle Scholar
  15. 15.
    Arkenau HT, Chong G, Cunningham D et al (2007) Gemcitabine, cisplatin and methylprednisolone for the treatment of patients with peripheral T-cell lymphoma: the Royal Marsden Hospital experience. Haematologica 92(2):271–272. CrossRefPubMedGoogle Scholar
  16. 16.
    Dong M, He XH, Liu P et al (2013) Gemcitabine-based combination regimen in patients with peripheral T-cell lymphoma. Med Oncol 30(1):351. CrossRefPubMedGoogle Scholar
  17. 17.
    Jia B, Hu S, Yang J et al (2016) Comparison of gemcitabin, cisplatin, and dexamethasone (GDP), CHOP, and CHOPE in the first-line treatment of peripheral T-cell lymphomas. Hematology 21(9):536–541. CrossRefPubMedGoogle Scholar
  18. 18.
    Kim JG, Sohn SK, Chae YS et al (2006) CHOP plus etoposide and gemcitabine (CHOP-EG) as front-line chemotherapy for patients with peripheral T cell lymphomas. Cancer Chemother Pharmacol 58(1):35–39. CrossRefPubMedGoogle Scholar
  19. 19.
    Swerdlow SH, Campo E, Harris NL et al (2008) WHO classification of tumours of haematopoietic and lymphoid tissues, Fourth edn. IARC WHO Classification of Tumours, No 2Google Scholar
  20. 20.
    Cheson BD, Fisher RI, Barrington SF et al (2014) Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 32(27):3059–3068. CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Rüdiger T, Weisenburger DD, Anderson JR et al (2002) Peripheral T-cell lymphoma (excluding anaplastic large-cell lymphoma): results from the non-Hodgkin’s Lymphoma Classification Project. Ann Oncol 13(1):140–149. CrossRefPubMedGoogle Scholar
  22. 22.
    Xie W, Hu K, Xu F et al (2013) Significance of clinical factors as prognostic indicators for patients with peripheral T-cell non-Hodgkin lymphoma: a retrospective analysis of 252 cases. Mol Clin Oncol 1(5):911–917. CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Mahadevan D, Unger JM, Spier CM et al (2013) Phase 2 trial of combined cisplatin, etoposide, gemcitabine, and methylprednisolone (PEGS) in peripheral T cell non-Hodgkin lymphoma: Southwest Oncology Group Study S0350. Cancer 119(2):371–379. CrossRefPubMedGoogle Scholar
  24. 24.
    Gleeson M, Peckitt C, To YM et al (2018) CHOP versus GEM-P in previously untreated patients with peripheral T-cell lymphoma (CHEMO-T): a phase 2, multicentre, randomised, open-label trial. Lancet Haematol 5(5):e190–e200. CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of LymphomaPeking University Cancer Hospital and InstituteBeijingChina

Personalised recommendations