DA-R-EPOCH
Practical Info for Patients
Purpose
This website is designed to be informational with the goal of providing patients with practical information about what they can expect and how they can respond.
DA-R-EPOCH
DA-R-EPOCH stands for Dose Adjusted R-EPOCH, where the letters “R-EPOCH” each represent a medication used in this chemotherapy regimen (see “MEDICINES” tab).
When going through DA-R-EPOCH, the same medications are administered each cycle but the strength is adjusted. My doctor started me at level 1 for cycle 1 and then increased the strength each cycle to level 2 for cycle 2, then level 3 for cycle 3, then level 4 for cycle 4. After cycle 4 we did a follow up PET scan and my doctor decided level 4 was the appropriate strength for my situation given the balance of response and side effects. So I was at level 4 R-EPOCH for cycles 4, 5, and 6. Per my conversation with my doctor, my understanding is that we could have gone to stronger levels if they thought it was needed to fight the cancer but given the more severe side effects I started experiencing at level 4 (such as neutropenia and the issues that come with it) and how well the cancer seemed to be responding to the chemotherapy (we did another PET scan after cycle 4 to observe the progress), they didn’t think it was worth it/necessary to increase the strength.
My Background
My name is is Sabina Samipour-Biel. I was diagnosed with Stage IV Primary Mediastinal Diffuse Large B-Cell Lymphoma in August 2020. I had become symptomatic with an advanced case of SVC Syndrome.
I want this website to be focused on DA-R-EPOCH content so I’m leaving out other details about my experience. That said, if you would like to talk about anything I have not included, I welcome you to reach out to me!
Saying I was lucky to develop SVC Syndrome is and understatement; if it had not been for the life-threatening symptoms of SVC Syndrome, the Lymphoma would likely have gone undetected for much much longer. One thing I would like to emphasize is that my experience absolutely affirms the idea that you or someone that cares about you needs to be your advocate. As an extreme example, my first chest x-ray (ordered by a pulmonologist) was read as clear despite the very large tumor in the center of it. DO NOT hesitate to ask for more opinions or additional details if you think there is something wrong.