Treatment of posttransplant lymphoproliferative disorder with poor prognostic features in children and young adults: Short-course EPOCH regimens are safe and effective

Pediatr Blood Cancer. 2021 Aug;68(8):e29126. doi: 10.1002/pbc.29126. Epub 2021 May 21.

Abstract

No guidelines exist for which intensive chemotherapy regimen is best in pediatric or young adult patients with high-risk posttransplant lymphoproliferative disorder (PTLD). We retrospectively reviewed patients with PTLD who received interval-compressed short-course etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin (SC-EPOCH) regimens at our institution. Eight patients were included with median age of 12 years. All patients achieved a complete response with a manageable toxicity profile. Two patients developed second, clonally unrelated, EBV-positive PTLD and one patient had recurrence at 6 months off therapy. No graft rejection occurred during therapy. All eight patients are alive with median follow-up of 29 months.

Keywords: EPOCH; PTLD; solid organ transplant.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Child
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Etoposide / therapeutic use
  • Humans
  • Lymphoproliferative Disorders* / drug therapy
  • Lymphoproliferative Disorders* / etiology
  • Organ Transplantation / adverse effects*
  • Postoperative Complications
  • Prednisone / therapeutic use
  • Prognosis
  • Retrospective Studies
  • Vincristine / therapeutic use
  • Young Adult

Substances

  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone

Supplementary concepts

  • EPOCH protocol