A novel conditioning regimen of chidamide, cladribine, gemcitabine, and busulfan in the autologous stem cell transplantation of aggressive T-cell lymphoma

BackgroundThe prognosis of patients with peripheral T-cell (PTCL) or lymphoblastic T-cell lymphoma (T-LBL) remains poor under current conditioning regimens before receiving autologous stem cell transplantation (ASCT). MethodsPatients with PTCL or T-LBL were enrolled to receive ASCT using the conditioning regimen of chidamide, cladribine, gemcitabine, and busulfan (ChiCGB). Positron emission tomography-computed tomography (PET/CT) was used to evaluate the response to ASCT. Overall survival (OS) and progression-free survival (PFS) were employed to assess the patient outcome, and adverse events were used to assess the regimen's safety. The survival curve was estimated via the Kaplan-Meier method. ResultsTwenty-five PTCL and 11 T-LBL patients were recruited. The median time to neutrophile and platelet engraftments was 10 days (8-13 days) and 13 days (9-31 days), respectively. The 3-year PFS and OS were 81.3 +/- 7.2% and 88.5 +/- 5.4% for all patients; 92.0 +/- 5.4% and 81.2 +/- 8.8% for PTCL patients; and both 81.8 +/- 11.6% for T-LBL patients, respectively. The 3-year PFS and OS were both 92.9 +/- 4.9% for patients with complete response (CR) but 50.0 +/- 17.7% and 75.0 +/- 15.3% for patients with non-CR, respectively. Infection was the most common non-hematological toxicity, and all toxicities were mild and controllable. ConclusionsChiCGB was a potentially effective and well-tolerated conditioning regimen to improve the prognosis of patients with aggressive T-cell lymphoma. Future randomized controlled trials are needed to assess ChiCGB as a conditioning regimen for ASCT.

Automated summary

The conditioning regimen of chidamide, cladribine, gemcitabine, and busulfan (ChiCGB) was effective in improving the prognosis of patients with peripheral T-cell (PTCL) or lymphoblastic T-cell lymphoma (T-LBL) undergoing autologous stem cell transplantation (ASCT). The regimen resulted in favorable overall survival and progression-free survival, with manageable adverse events. Randomized controlled trials are needed to further evaluate ChiCGB as a conditioning regimen for ASCT.