Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2022; 10(4): 1341-1348
Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1341
Chidamide combined with traditional chemotherapy for primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma: A case report
Zhen-Dong He, Hai-Yan Yang, Sheng-Sheng Zhou, Man Wang, Qin-Li Mo, Feng-Xiang Huang, Zhi-Gang Peng
Zhen-Dong He, Hai-Yan Yang, Sheng-Sheng Zhou, Man Wang, Qin-Li Mo, Feng-Xiang Huang, Zhi-Gang Peng, Department of Medical Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: He ZD, Yang HY, and Peng ZG contributed to the data analysis and interpretation and manuscript writing; He ZD and Peng ZG contributed to the conception and design; He ZD, Yang HY, Zhou SS, Wang M, Mo QL, and Huang FX contributed to the collection and assembly of data; Peng ZG contributed to the administrative support and final approval of the manuscript; all authors have read and approved the final manuscript.
Supported by the China Anti-Cancer Association Project, No. CORP-117.
Informed consent statement: We obtained the patient’s written informed consent to publish the details of their cases and the associated images.
Conflict-of-interest statement: The authors declare that there were no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Gang Peng, MD, PhD, Chief Doctor, Professor, Department of Medical Oncology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuang Yong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. pengzhigang@gxmu.edu.cn
Received: August 5, 2021
Peer-review started: August 5, 2021
First decision: November 6, 2021
Revised: November 11, 2021
Accepted: December 25, 2021
Article in press: December 25, 2021
Published online: February 6, 2022
Abstract
BACKGROUND

Traditional chemotherapy has benefited many patients with non-Hodgkin's lymphoma, but results in a very poor response in patients with rare lymphomas or refractory lymphomas. Previous studies have shown that chidamide has potential anti-lymphoma activity and reverses lymphoma cell chemoresistance to increase the chemosensitivity of lymphoma cells to traditional chemotherapy.

CASE SUMMARY

A 14-year-old boy was admitted to our hospital with a 5-d history of generalized erythema, papules, and blisters. Initially, the disease was refractory to potent anti-allergic and anti-infective treatment, and his condition progressively worsened. Skin biopsy revealed primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma. Considering that the disease is extremely rare in clinical practice, existing case reports have shown poor efficacy with traditional chemotherapy alone. We recommend chidamide combined with traditional chemotherapy for treatment. The regimen was as follows: Chidamide 30 mg/biw, cyclophosphamide 1100 mg/d1, pirarubicin 70 mg/d1, vincristine 2 mg/d1, dexamethasone 20 mg/d1-5, etoposide 100 mg/d1-5, in a 21 d cycle. The treatment effect was considerable, and complete remission was achieved after 4 cycles of treatment, after which the patient completed a total of 6 cycles of treatment. Subsequently, the patient regularly took chidamide 20 mg/biw as maintenance therapy for 1 year. To date, the patient has been disease-free for 3 years.

CONCLUSION

This case suggests that the combination of chidamide and traditional chemotherapy is effective in primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma.

Keywords: Chidamide, Primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma, Traditional chemotherapy, Case report

Core Tip: The long-term efficacy of traditional chemotherapy in the treatment of primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma is poor, and the main mechanism is the emergence of chemoresistance in lymphoma cells. Chidamide induces apoptosis and growth arrest of lymphoid and hematologic tumor cells and enhances the sensitivity of lymphoma cells to traditional chemotherapy. This case suggests that chidamide may enhance the efficacy of traditional chemotherapy, and that chidamide combined with traditional chemotherapy may be a promising treatment option for primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma.