Affiliation:
1. National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University
2. Department of Dermatology, Affiliated Huai’an Hospital of Xuzhou Medical University
3. The University of Texas M.D. Anderson Cancer Center
Abstract
Abstract
This study aimed to evaluate the efficacy and safety of chidamide (Chi) combined with a modified Busulfan-Cyclophosphamide (mBuCy) conditioning regimen for T-cell acute lymphoblastic leukemia/lymphoma (T-ALL/LBL) patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Twenty-two patients received chidamide combined with mBuCy conditioning regimen (Chi group). A control (CON) group of 82 patients received mBuCy only in the same period. The leukemia-free survival (LFS), overall survival (OS), cumulative incidence of relapse (CIR), and non-relapse-related mortality (NRM) were evaluated. Patients in the Chi group were associated with lower 2-year CIR (19.0 vs. 38.4%, P= 0.030), better 2-year LFS (76.1 vs. 51.6%, P = 0.027), and had a trend towards better 2-year OS (80.5 vs. 60.4%, P= 0.063). Patients with minimal residual disease (MRD) positive before HSCT in the Chi group exhibited an advantage in 2-year OS and LFS, despite no significant differences (75.0 vs. 18.6%, P = 0.068; 75.0 vs. 24.1%, P = 0.070, respectively). The cumulative incidence rates of grade II-IV aGVHD were similar (36.4 vs. 39.0%, P = 0.820). The most common non-hematologic adverse event was gastrointestinal tract. Hepatic dysfunction was more often observed in the Chi group. 20 patients in Chi group evinced an elevation in γ-glutamyltransferase, as compared to the mBuCy group (90.9 vs. 65.9%, P= 0.021). No transplantation-related mortality was documented within the first 100 days after transplantation. The results demonstrate that the chidamide intensified regimen may be an effective and acceptable safety option for T-ALL/LBL undergoing allo-HSCT.
Publisher
Research Square Platform LLC