{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T21:28:19Z","timestamp":1763069299350,"version":"3.40.5"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,9]],"date-time":"2019-11-09T00:00:00Z","timestamp":1573257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008615","name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill","doi-asserted-by":"publisher","award":["P30CA016086"],"award-info":[{"award-number":["P30CA016086"]}],"id":[{"id":"10.13039\/100008615","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011072","name":"Center for AIDS Research, University of North Carolina at Chapel Hill","doi-asserted-by":"publisher","award":["P30AI5041"],"award-info":[{"award-number":["P30AI5041"]}],"id":[{"id":"10.13039\/100011072","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K01TW009488","R21CA180815","U54CA190152"],"award-info":[{"award-number":["K01TW009488","R21CA180815","U54CA190152"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Aggressive non\u2010Hodgkin lymphoma (NHL) is among the most common cancers in sub\u2010Saharan Africa (SSA), where CHOP is standard treatment and outcomes are poor. To address this, we treated 17 newly diagnosed adult patients in Malawi with Burkitt (n\u00a0=\u00a08), plasmablastic (n\u00a0=\u00a08), and primary effusion lymphoma (n\u00a0=\u00a01) with a modified EPOCH regimen between 2016 and 2019. Twelve patients (71%) were male and the median age was 40\u00a0years (range 16\u201063). Eleven (65%) were HIV infected, median CD4 count was 218 cells\/\u00b5L (range 9\u2010460), and nine (82%) had suppressed HIV RNA\u00a0&lt;\u00a0400 copies\/mL. Patients received a median of six cycles (range 2\u20108) and median follow\u2010up was 14\u00a0months (range 2\u201034) among patients still alive. Grade 3\/4 neutropenia was observed in 26% of cycles and in 65% of patients. Sixteen (94%) responded to EPOCH and 10 (59%) achieved a complete response. One\u2010year overall survival (OS) was 62% (95% confidence interval [CI], 42%\u201091%). Five patients (29%) died from progressive NHL and three (18%) from treatment\u2010related complications. These data suggest EPOCH with setting\u2010appropriate modifications may be a practical, safe, and effective option for improving high\u2010risk NHL outcomes in Malawi and comparable settings, which deserves further prospective evaluation.<\/jats:p>","DOI":"10.1002\/cam4.2631","type":"journal-article","created":{"date-parts":[[2019,11,9]],"date-time":"2019-11-09T08:39:40Z","timestamp":1573288780000},"page":"77-83","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Modified EPOCH for high\u2010risk non\u2010Hodgkin lymphoma in sub\u2010Saharan Africa"],"prefix":"10.1002","volume":"9","author":[{"given":"Takondwa","family":"Zuze","sequence":"first","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5105-965X","authenticated-orcid":false,"given":"Grace K.","family":"Ellis","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edwards","family":"Kasonkanji","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bongani","family":"Kaimila","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"},{"name":"University of Malawi College of Medicine Blantyre Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Nyasosela","sequence":"additional","affiliation":[{"name":"Kamuzu Central Hospital Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Nyirenda","sequence":"additional","affiliation":[{"name":"Kamuzu Central Hospital Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamiwe","family":"Tomoka","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"},{"name":"University of Malawi College of Medicine Blantyre Malawi"},{"name":"University of North Carolina Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurice","family":"Mulenga","sequence":"additional","affiliation":[{"name":"Kamuzu Central Hospital Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Chikasema","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blessings","family":"Tewete","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asekanadziwa","family":"Mtangwanika","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Chiyoyola","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fred","family":"Chimzimu","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Coxcilly","family":"Kampani","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilberforce","family":"Mhango","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Nicholas","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cara","family":"Randall","sequence":"additional","affiliation":[{"name":"University of North Carolina Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1765-6623","authenticated-orcid":false,"given":"Nathan D.","family":"Montgomery","sequence":"additional","affiliation":[{"name":"University of North Carolina Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Fedoriw","sequence":"additional","affiliation":[{"name":"University of North Carolina Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine D.","family":"Westmoreland","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"},{"name":"University of North Carolina Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew S.","family":"Painschab","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"},{"name":"University of North Carolina Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satish","family":"Gopal","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi Lilongwe Malawi"},{"name":"University of Malawi College of Medicine Blantyre Malawi"},{"name":"University of North Carolina Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,11,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.148809"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(16)30143-7"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011795"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70235-2"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V97.11.3370"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdf253"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V99.8.2685"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1308392"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-10-567479"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2019-01-893339"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hon.2437_122"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-02-387092"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-04-844472"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13027-018-0195-4"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018029199"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30682"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13986"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0150445"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqw118"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.54.8800"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15625"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.2631","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.2631","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.2631","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T19:21:36Z","timestamp":1694114496000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.2631"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,9]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1002\/cam4.2631"],"URL":"https:\/\/doi.org\/10.1002\/cam4.2631","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"type":"print","value":"2045-7634"},{"type":"electronic","value":"2045-7634"}],"subject":[],"published":{"date-parts":[[2019,11,9]]},"assertion":[{"value":"2019-07-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}