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Chidamide Maintenance Safe After T-ALL/LBL Transplant

May, 05, 2024 | Leukemia, Lymphoma

KEY TAKEAWAYS

  • The study aimed to assess the efficacy and safety of irradiation-containing conditioning and post-transplant chidamide maintenance in patients with T-ALL/LBL.
  • The endpoints were relapse, GVHD, TRM, PFS, OS, and AEs.
  • The study concluded that chidamide maintenance is safe post-T-ALL/LBL transplant, but efficacy requires further investigation.

T-cell acute lymphoblastic leukemia/lymphoblastic lymphoma (T-ALL/LBL) are highly malignant and aggressive hematologic tumors with no standard first-line treatment. Chidamide, a novel histone deacetylase inhibitor, shows significant promise.

Xueying Wang and the team aimed to assess the efficacy and safety of an irradiation-containing conditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT) and post-transplant chidamide maintenance in individuals with T-ALL/LBL.

The study retrospectively analyzed clinical data from 6 individuals with T-ALL/LBL who underwent allo-HSCT with a radiotherapy-containing pretreatment regimen followed by post-transplant chidamide maintenance therapy. The endpoints included relapse, graft-versus-host disease (GVHD), transplant-related mortality (TRM), progression-free survival (PFS), overall survival (OS), and adverse events (AEs).

The results revealed that all patients experienced uneventful post-transplant hematopoietic reconstitution and achieved complete molecular remission within 30 days. All 6 individuals survived, with 2 experiencing relapse at a median of 828.5 days (range 170-1335 days). The 1-year OS rate was 100%, the 2-year PFS rate was 66.7%, and the TRM rate was 0%.

Post-transplantation, 2 individuals developed grade I-II acute GVHD, with no cases of grade III-IV acute or chronic GVHD observed. The most common AEs following chidamide administration were hematological, affecting all patients to varying degrees. Additionally, 2 individuals experienced grade 2 liver function abnormalities, and one individual reported grade 1 malaise.

The study concluded that while chidamide maintenance therapy post-T-ALL/LBL transplantation appears safe, further investigation is warranted regarding its efficacy.

No funding-related information was available.

Source: https://pubmed.ncbi.nlm.nih.gov/38776229/ 

Wang X, Deng Y, He G, (2024). “A retrospective study of an irradiation-based conditioning regimen and chidamide maintenance therapy in T-ALL/LBL.” Hematology. 2024 Dec;29(1):2356300. doi: 10.1080/16078454.2024.2356300. Epub 2024 May 22. PMID: 38776229.

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