Sustained yet non-curative response to lenalidomide in relapsed angioimmunoblastic T-cell lymphoma with acquired chidamide resistance: a case report with 10-year follow-up, genetic insights and literature review.

Autor:	Xu J; Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, Chengdu, China., Huang J; Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, Chengdu, China., Xie L; Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, Chengdu, China., Liu T; Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, Chengdu, China., Li J; Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, Chengdu, China., Chen X; Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, Chengdu, China., Liu Z; Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, Chengdu, China., Zhao S; Department of Pathology, West China Hospital, Sichuan University, Chengdu, China., Xu C; Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, Chengdu, China.; Chengdu Shang Jin Nan Fu Hospital / Shang Jin Hospital of West China Hospital, Sichuan University, Chengdu, China., Wu Y; Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, Chengdu, China.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2024 Nov 27; Vol. 14, pp. 1471090. Date of Electronic Publication: 2024 Nov 27 (Print Publication: 2024).
DOI:	10.3389/fonc.2024.1471090
Abstrakt:	Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive subtype of peripheral T-cell lymphoma (PTCL) characterized by its T-follicular helper (TFH) phenotype. Relapsed and refractory disease is common in AITL and often associated with a poor prognosis. The presence of epigenetic abnormalities, immune dysregulation, hyperinflammation and active angiogenesis in AITL offers potential targets for histone deacetylase (HDAC) inhibitors and immunomodulatory drugs (IMiDs). Herein, we present a case of AITL with multiple relapses over a decade. Following intensive chemotherapy and autologous stem cell transplantation (ASCT), the patient relapsed with extensive nodal and extranodal involvement, particularly pulmonary lesions, and subsequently pursued chemo-free treatments. Initially, the patient exhibited a remarkable response to single-agent chidamide, the first oral HDAC inhibitor. Soon after developing resistance to chidamide, continuous treatment with lenalidomide led to an impressive sustained complete remission lasting 64 months, followed by a diminished response for an additional 11 months. Genetic profiling of the patient revealed mutations in KMT2D and ARID1A, along with chromosomal aberrations such as del(5q). Notably, genes commonly mutated in AITL, including RHOA, TET2, DNMT3A, and IDH2, were absent in this case. A review of the literature highlights the heterogeneous genomic landscape of AITL and the diversity of treatment options available, underscoring the importance of tailored approaches to overcome resistance and improve outcomes in this distinct lymphoma subtype. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Xu, Huang, Xie, Liu, Li, Chen, Liu, Zhao, Xu and Wu.)
Databáze:	MEDLINE
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