Real-world data of azacitidine for relapsed/refractory nodal T-follicular helper cell lymphoma in 11 patients

Philipp Faustmann^1*Jan Christian Schroeder¹Andreas Riedel¹Simon Killinger¹Laurent Phely¹Lucas Mix¹Claudia Lengerke^1,2Max-Felix Häring¹

• ¹Internal Medicine II – Hematology, Oncology, Clinical Immunology, Rheumatology, University Hospital Tuebingen, Tuebingen, Germany
• ²German Cancer Consortium (DKTK), partner side Tuebingen, a partnership between DKFZ and University Hospital Tuebingen, Tuebingen, Germany

Relapsed or refractory (r/r) nodal T-follicular helper cell lymphoma of the angioimmunoblastic type is a rare disease with a dismal prognosis. This disease usually harbors mutations in epigenetic modifiers. A standard of treatment for r/r disease is not known. Here, we report real-world data of 11 patients with a median age of 73 years, treated with azacitidine, a hypomethylating agent. Overall survival was 182 days. Five patients died from progressive disease, three are in complete remission after allogenic stem cell transplantation, two are in complete remission still receiving azacitidine and one is under treatment for relapse. Tolerability of the treatment was well despite the advanced age and a high burden of comorbidities with a median hematopoietic cell transplantationspecific comorbidity index (HCT-CI) of 5, a score to identify relevant comorbidities. However, grade 3 or 4 hematological toxicity occurred in nine patients. Azacitidine may be a suitable treatment option for some patients with r/r nodal T-follicular helper cell lymphoma. each 28-day cycle in ten patients, unless adverse events necessitated discontinuation. One patient received 300 mg aza orally together with his DLBCL treatment.