Published online Jul 26, 2020. doi: 10.12998/wjcc.v8.i14.3122
Peer-review started: March 14, 2020
First decision: April 22, 2020
Revised: April 26, 2020
Accepted: July 4, 2020
Article in press: July 4, 2020
Published online: July 26, 2020
Processing time: 132 Days and 9.4 Hours
Hepatosplenic T-cell lymphoma (HSTCL) is a rare subtype of non-Hodgkin’s lymphoma, which has an aggressive clinical course and an extremely poor prognosis. Chidamide is a novel, orally active, benzamide-type histone deacetylase (HDAC) inhibitor that has been used for peripheral T-cell lymphoma (PTCL) treatment. However, to date, there has been no report of the treatment and effect of the HDAC inhibitor chidamide in HSTCL, which is a special subtype of PTCL.
A 45-year-old male patient was admitted with splenomegaly and slight bicytopenia. He was diagnosed with HSTCL via splenectomy. The patient was treated with fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with high-dose methotrexate and cytarabine regiment as inductive therapy. Unfortunately, the disease progressed rapidly during chemotherapy before a suitable allogeneic gene transplant donor was found. The chidamide-combined chemotherapy regimen and single-drug oral maintenance regimen achieved complete remission, duration of response of 9 mo, and overall survival of 15 mo.
The novel agent chidamide can be used in HSTCL to achieve deep remission and improve the duration of response and overall survival.
Core tip: Hepatosplenic T-cell lymphoma is a rare disease that progresses quickly and has a poor prognosis. Patients usually show short-term rapid disease progress with a traditional inductive regimen, leaving no opportunity for hematopoietic stem cell transplantation. We employed the histone deacetylase inhibitor chidamide combined with a dose-adjusted ifosfamide, carboplatin, etoposide regimen, and chidamide single-drug oral maintenance therapy for the management of this patient, which had a satisfactory outcome.