International Journal of Hematology

, Volume 108, Issue 2, pp 167–175 | Cite as

EPOCH regimen as salvage therapy for adult T-cell leukemia–lymphoma

  • Eo Toriyama
  • Yoshitaka ImaizumiEmail author
  • Hiroaki Taniguchi
  • Jun Taguchi
  • Jun Nakashima
  • Hidehiro Itonaga
  • Shinya Sato
  • Koji Ando
  • Yasushi Sawayama
  • Tomoko Hata
  • Takuya Fukushima
  • Yasushi Miyazaki
Original Article


Adult T-cell leukemia–lymphoma (ATL) is an intractable hematopoietic malignancy with a very poor prognosis. Although improved responses have been achieved through intensive chemotherapy in newly diagnosed patients with aggressive ATL, most patients suffer from relapse or disease recurrence, and an effective salvage therapy, especially for candidates for allogeneic hematopoietic stem cell transplantation (allo-HSCT), is yet to be established. The efficacy of the EPOCH regimen has been reported for several lymphoid malignancies; however, its efficacy for ATL has not been sufficiently evaluated. Here, we report results of a study of the EPOCH regimen as a salvage therapy for ATL. We retrospectively analyzed patients with relapsed or refractory ATL treated in our institution, with EPOCH as a first salvage therapy. Fourteen patients with a median age of 58 years were analyzed, among whom eight achieved a response, including a complete response in one patient and partial responses in seven. Seven patients underwent allo-HSCT after EPOCH therapy; however, the median overall survival (OS) could not be determined, whereas OS at 2 years after allo-HSCT was estimated to be 85.7%. These results suggest that EPOCH is an option for salvage therapy in patients with ATL, including candidates for allo-HSCT.


Adult T-cell leukemia–lymphoma (ATL) EPOCH regimen Salvage therapy 



We thank the hematologists in the Department of Hematology, Nagasaki University Hospital, for diagnosis and treatment of patients with ATL. We would like to thank Editage ( for English language editing.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to declare.


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Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  • Eo Toriyama
    • 1
  • Yoshitaka Imaizumi
    • 2
    Email author
  • Hiroaki Taniguchi
    • 3
  • Jun Taguchi
    • 4
  • Jun Nakashima
    • 5
  • Hidehiro Itonaga
    • 2
  • Shinya Sato
    • 2
  • Koji Ando
    • 2
  • Yasushi Sawayama
    • 2
  • Tomoko Hata
    • 2
  • Takuya Fukushima
    • 6
  • Yasushi Miyazaki
    • 1
  1. 1.Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine UnitNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
  2. 2.Department of HematologyNagasaki University HospitalNagasakiJapan
  3. 3.Department of HematologySasebo City General Medical CenterNagasakiJapan
  4. 4.Department of HematologyJapanese Red Cross Nagasaki Genbaku HospitalNagasakiJapan
  5. 5.Department of HematologyNational Hospital Organization Nagasaki Medical CenterNagasakiJapan
  6. 6.Laboratory of Hematoimmunology, School of Health Sciences, Faculty of MedicineUniversity of the RyukyusOkinawaJapan

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