EPOCH is an intensive chemotherapy regimen intended for treatment of aggressive non-Hodgkin's lymphoma.
The R-EPOCH regimen consists of: This regimen requires the use of prophylactic antibiotics to prevent infectious complications, as well as the use of colony-stimulating factors (G-CSF) from the first day after the end of chemotherapy to the day of full blood count restoration (ANC > 1000/μL).
This approach is called "dose-adjusted EPOCH", or "DA-EPOCH" (DA-EPOCH-R, DA-R-EPOCH or R-DA-EPOCH are used when rituximab is included).
Dose change rules are as follows:[citation needed] Twice a week a full blood count with white blood cell count (WBC) differential is obtained.
If the nadir ANC < 500/μL on one or two blood checks, but ANC rises above 500 at the time of third check (i.e. the duration of agranulocytosis is less than nine days), and the nadir of platelet count is > 25,000/μL, then the dose for the next course will remain the same.