Chidamide‑augmented BEAM conditioning and maintenance in first-remission T‑cell lymphoma: a single‑arm phase 2 experience

T‑cell lymphoma (TCL) is a rare subset of non‑Hodgkin lymphoma (NHL), accounting for 5–10% of cases in Western countries and 15–20% in Asia [ 1 ]. TCL encompasses multiple pathological subtypes, including nodal T‑follicular helper cell lymphoma, angioimmunoblastic‑type (nTFHL‑AI), peripheral T‑cell lymphoma‑not otherwise specified (PTCL‑NOS), and anaplastic large‑cell lymphoma (ALCL) [ 2 ]. First‑line CHOP‑based regimens yield unsatisfactory outcomes [ 2 ]. Autologous stem cell transplantation (ASCT) is a standard consolidation strategy for TCL in first remission, yet the 2‑year progression‑free survival (PFS) with BEAM conditioning is only 52.9% [ 3 ]. Chidamide, an oral HDAC1/2/3/10 inhibitor, has demonstrated efficacy in relapsed/refractory TCL [ 4 ]. Preclinical studies suggest synergistic effects with chemotherapeutic agents such as cytarabine and etoposide [ 5 ]. However, no study has systematically integrated chidamide into the BEAM (carmustine, etoposide, cytarabine, and melphalan) backbone to improve transplant outcomes.