Chu Ming-Qiang, Zhang Ting-Juan, Yang Qian, Feng Yuan, Lu Chao, Ji Yong-Hui, Qian Jun, Zhou Jing-Dong
Department of Hematology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
Institute of Hematology, Jiangsu University, Zhenjiang, Jiangsu, China.
Front Pharmacol. 2025 May 15;16:1554501. doi: 10.3389/fphar.2025.1554501. eCollection 2025.
Angioimmunoblastic T-cell lymphoma (AITL), a highly aggressive peripheral T-cell lymphoma (PTCL), carries a poor prognosis in elderly patients due to frequent relapse and limited salvage options after multiline therapy. We present the case of an 80-year-old woman with relapsed/refractory (R/R) AITL who relapsed after CHOP and exhibited resistance to the following sequential therapies: second-line chidamide plus COP and third-line chidamide with mitoxantrone hydrochloride liposome. Molecular analysis revealed and mutations, reflecting disease complexity. Salvage therapy with linperlisib, a selective PI3Kδ inhibitor, combined with gemcitabine/oxaliplatin induced sustained partial remission, followed by linperlisib maintenance. The regimen demonstrated exceptional safety, with no grade ≥2 toxicities, even in this frail population. This case highlights the dual role of linperlisib as an effective and well-tolerated therapy for elderly R/R AITL patients who have exhausted prior lines. By precisely targeting PI3Kδ, our findings offer critical real-world evidence to address the unmet need for safe salvage strategies in this vulnerable population.
血管免疫母细胞性T细胞淋巴瘤（AITL）是一种侵袭性很强的外周T细胞淋巴瘤（PTCL），由于老年患者频繁复发且多线治疗后挽救方案有限，其预后较差。我们报告了一例80岁复发/难治性（R/R）AITL女性患者，她在CHOP方案治疗后复发，并对后续的二线西达本胺联合COP方案以及三线西达本胺联合盐酸米托蒽醌脂质体治疗耐药。分子分析显示存在 和 突变，反映了疾病的复杂性。使用选择性PI3Kδ抑制剂林普利塞联合吉西他滨/奥沙利铂进行挽救治疗诱导了持续部分缓解，随后进行林普利塞维持治疗。该方案显示出极佳的安全性，即使在这个体弱的人群中也没有≥2级毒性反应。本病例突出了林普利塞对于既往治疗线数已用尽的老年R/R AITL患者而言，作为一种有效且耐受性良好的治疗方法的双重作用。通过精准靶向PI3Kδ，我们的研究结果为满足这一脆弱人群对安全挽救策略的未满足需求提供了关键的真实世界证据。
