{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T11:30:37Z","timestamp":1792668637795,"version":"4.5.0"},"reference-count":41,"publisher":"American Society of Hematology","issue":"11","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,9,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) is a preferred regimen for HIV-non-Hodgkin lymphomas (HIV-NHLs), which are frequently Epstein-Barr virus (EBV) positive or human herpesvirus type-8 (HHV-8) positive. The histone deacetylase (HDAC) inhibitor vorinostat disrupts EBV\/HHV-8 latency, enhances chemotherapy-induced cell death, and may clear HIV reservoirs. We performed a randomized phase 2 study in 90 patients (45 per study arm) with aggressive HIV-NHLs, using dose-adjusted EPOCH (plus rituximab if CD20+), alone or with 300 mg vorinostat, administered on days 1 to 5 of each cycle. Up to 1 prior cycle of systemic chemotherapy was allowed. The primary end point was complete response (CR). In 86 evaluable patients with diffuse large B-cell lymphoma (DLBCL; n = 61), plasmablastic lymphoma (n = 15), primary effusion lymphoma (n = 7), unclassifiable B-cell NHL (n = 2), and Burkitt lymphoma (n = 1), CR rates were 74% vs 68% for EPOCH vs EPOCH-vorinostat (P = .72). Patients with a CD4+ count &amp;lt;200 cells\/mm3 had a lower CR rate. EPOCH-vorinostat did not eliminate HIV reservoirs, resulted in more frequent grade 4 neutropenia and thrombocytopenia, and did not affect survival. Overall, patients with Myc+ DLBCL had a significantly lower EFS. A low diagnosis-to-treatment interval (DTI) was also associated with inferior outcomes, whereas preprotocol therapy had no negative impact. In summary, EPOCH had broad efficacy against highly aggressive HIV-NHLs, whereas vorinostat had no benefit; patients with Myc-driven DLBCL, low CD4, and low DTI had less favorable outcomes. Permitting preprotocol therapy facilitated accruals without compromising outcomes. This trial was registered at www.clinicaltrials.gov as #NCT0119384.<\/jats:p>","DOI":"10.1182\/blood.2019003959","type":"journal-article","created":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T00:54:31Z","timestamp":1589936071000},"page":"1284-1297","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":60,"title":["Impact of Myc in HIV-associated non-Hodgkin lymphomas treated with EPOCH and outcomes with vorinostat (AMC-075 trial)"],"prefix":"10.1182","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6282-4406","authenticated-orcid":false,"given":"Juan C.","family":"Ramos","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Miami School of Medicine, Miami, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Sparano","sequence":"additional","affiliation":[{"name":"Department of Oncology, Albert Einstein Comprehensive Cancer Center, Bronx, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Chadburn","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4029-8641","authenticated-orcid":false,"given":"Erin G.","family":"Reid","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, San Diego, San Diego, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4027-3073","authenticated-orcid":false,"given":"Richard F.","family":"Ambinder","sequence":"additional","affiliation":[{"name":"Department of Oncology, Johns Hopkins University, Baltimore, MD;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9824-6612","authenticated-orcid":false,"given":"Eric R.","family":"Siegel","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Page C.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0724-461X","authenticated-orcid":false,"given":"Paul G.","family":"Rubinstein","sequence":"additional","affiliation":[{"name":"Section of Hematology\/Oncology, John H. 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