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Romidepsin-induced durable remission for relapsed nodal peripheral T-cell lymphoma with T follicular helper phenotype after allogeneic hematopoietic cell transplantation

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Abstract

Patients with recurrent peripheral T-cell lymphoma (PTCL) after allogeneic hematopoietic cell transplantation (HCT) have dismal outcomes. Nodal PTCL with the T follicular helper phenotype (PTCL-TFH) is uniquely sensitive to histone deacetylase inhibitors compared to non-TFH phenotypes. We report the case of a 19-year-old man who experienced recurrence of PTCL-TFH shortly after allogeneic HCT and subsequently achieved durable remission with romidepsin. Before HCT, the patient had refractory disease after CHOP and ESHAP chemotherapies but achieved a partial response after two cycles of romidepsin as salvage treatment. HLA-haploidentical peripheral blood stem cell transplantation was performed using conditioning with fludarabine 180 mg/sqm, melphalan 80 mg/sqm, and total body irradiation 2 Gy, and graft-versus-host disease (GVHD) prophylaxis with post-transplantation cyclophosphamide. One month after HCT, disease progression was observed in the lung. Romidepsin was readministered every 2 weeks at a reduced dose of 12 mg/sqm. After two cycles of romidepsin, the patient achieved a complete metabolic response without severe GVHD or other non-hematological toxicities. Romidepsin was discontinued after seven treatment cycles due to prolonged lymphopenia. The patient remains in complete remission 30 months after the last dose of romidepsin. Our experience suggests that romidepsin could be safely administered soon after allogeneic transplantation.

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Data availability

The authors declare that data supporting the findings of this study are available within the article.

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Funding

This study was supported by the National Cancer Research and Development Fund (26-A-26).

Author information

Authors and Affiliations

  1. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Kayoko Tao, Yoshihiro Inamoto, Haruhi Furukawa, Rika Hosoba, Wataru Takeda, Jun Aoki, Ayumu Ito, Takashi Tanaka, Sung-Won Kim & Takahiro Fukuda

  2. Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan

    Kayoko Tao

  3. Department of Hematology, National Cancer Center Hospital, Tokyo, Japan

    Haruhi Furukawa, Rika Hosoba, Shinichi Makita, Suguru Fukuhara & Koji Izutsu

  4. Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan

    Akiko Maeshima

  5. Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo, Japan

    Keisuke Kataoka

Authors
  1. Kayoko Tao
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  2. Yoshihiro Inamoto
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  3. Haruhi Furukawa
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  4. Rika Hosoba
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  7. Jun Aoki
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  8. Ayumu Ito
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  9. Takashi Tanaka
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  11. Shinichi Makita
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  12. Suguru Fukuhara
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  15. Koji Izutsu
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  16. Takahiro Fukuda
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Contributions

KT and YI designed the study and wrote the manuscript. SM and YI are the attending physicians of this patient. SF, YK, and KK conducted genome profiling of the sample. AM conducted pathological diagnosis. HF, RH, WT, SM, KI, and TF wrote the manuscript. All authors reviewed the final version of the manuscript and have approved the submission of the final version of the manuscript for publication.

Corresponding author

Correspondence to Yoshihiro Inamoto.

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Conflict of interest

KT has received honorarium from Sysmex. YI has received honorarium from Novartis, Janssen, Meiji Seika Pharma, and Kyowa Kirin. SM has received honorarium from Celgene/Bristol Myers Squibb, Chugai, CSL Behring, Daiichi-Sankyo, Eisai, Novartis, SymBio, and Takeda, and has a consulting or advisory role of Takeda, Celgene/BMS, Daiichi-Sankyo, Novartis, Celgene/Bristol Myers Squib, Gilead Sciences, and Genmab. SF has received honorarium from Janssen, Takeda, Zenyaku, Otsuka, Astrazeneca, Abbvie, Ono, and Chugai, and a research fund from Chugai and Loxo Oncology. KK has received a research fund from Otsuka Pharmaceutical and honorarium from Otsuka Pharmaceutical and Bristol Myers Squibb. KI has received honorarium from Eisai, Chugai, Janssen, AstraZeneca, Novartis, Bristol Myers Squibb, Celgene, Kyowa Kirin, Abbvie, Ono Pharmaceutical, Eli Lilly, MSD, Daiichi Sankyo, Kyorin Pharmaceutical, Symbio, Takeda, Allergan Japan, and FIJIFILM Toyama Chemical, and a research grant from Celgene/Bristol Myers Squibb, MSD, AstraZeneca, AbbVie, Eisai, Incyte, Solasia Pharma, Novartis, Bayer, Pfizer, Janssen, Yakult, Kyowa Kirin, Ono Pharmaceutical, Daiichi Sankyo, Chugai, Takeda, Beigene, Genmab, Otsuka, and LOXO Oncology, and has a consulting or advisory role of Kyowa Kirin, Eisai, Genmab, AbbVie, Ono Pharmaceutical, Daiichi Sankyo, Takeda, Celgene, and AstraZeneca. Other authors declare no conflict of interest.

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Informed consent was obtained from the patient for the publication of this case report.

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Tao, K., Inamoto, Y., Furukawa, H. et al. Romidepsin-induced durable remission for relapsed nodal peripheral T-cell lymphoma with T follicular helper phenotype after allogeneic hematopoietic cell transplantation. Int J Hematol 118, 292–298 (2023). https://doi.org/10.1007/s12185-023-03561-7

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  • DOI: https://doi.org/10.1007/s12185-023-03561-7

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