Abstract: Clinical Outcomes of PEP-C Metronomic Chemotherapy Regimen on Relapsed and RefractoryNon-Hodgkin's LymphomaZhanhe PAN1, An SU1, XinWANG1, Huiqiang HUANG2, Jing ZHANG1, Xia LV1Correspondence to: An SU, E-mail: doctor_pan@sina.cn1Department of Oncology, Zhongshan Hospital of Xiamen University, Xiamen 361004, China2Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, ChinaAbstract Objective: To evaluate the therapeutic efficacy and adverse effect of PEP-C metronomic chemotherapy for relapsedand refractory non-Hodgkin's lymphoma ( NHL ). Methods: Clinical data of 23 patients with relapsed and refractory NHL treated withPEP-C metronomic chemotherapy were analyzed. Results: All of the 23 patients were assessable. The complete remission ( CR ) ratewas 30.4% ( 7/23 ), the partial remission ( PR ) rate was 30.4% ( 7/23 ), and the overall response ( OR ) rate was 60.8% ( 14/23 ). Theresponse rate was 81.8% ( 9/11 ) for low grade NHL and 41.7% ( 5/12 ) for intermediate or high grade NHL. The CR rate was 45.5% (5/11 ) for low grade NHL and 16.7% ( 2/12 ) for intermediate and high grade NHL ( P < 0.05 ). The response rate was 60.0% ( 9/15 )for low risk group ( IPI score 0-2 ) and 62.5% (5/8) for high risk group ( IPI score 3-5 ). The CR rate was 33.3% ( 5/15 ) for low riskgroup and 25.0% ( 2/8 ) for high risk group ( P > 0.05 ). Major adverse events included myelosuppression, nausea, vomiting and diar-rhea. These adverse effects could be treated and no treatment-related death occurred. Conclusion: PEP-C metronomic chemotherapyregimen is effective and well tolerated for patients with relapsed and refractory NHL, especially for those who cannot tolerate intensivechemotherapy. Further clinical study is warranted.Keywords Non-Hodgkin's lymphoma; Metronomic chemotherapy; Therapeutic efficacy; Adverse effectsnon-Hodgkin's