Challenging Management of Relapsed/Refractory Angioimmunoblastic T-Cell Lymphoma: Insights from Two Complex Cases with Long-Term Response to Belinostat

Peripheral T-cell lymphomas (PTCLs) are rare and aggressive non-Hodgkin lymphomas associated with poor prognosis, marked by a rapid progression and high relapse rates.Current treatment strategies, such as standard CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) chemotherapy, often fail to achieve long-term remission, and allogeneic stem cell transplantation (ASCT) is rarely feasible.Recent advancements include FDA-approved histone deacetylase inhibitors (HDACis), such as belinostat, which has shown promise in treating this aggressive hematological malignancy with a favourable safety profile.We present two clinical cases of relapsed/refractory (r/r) angioimmunoblastic T-cell lymphoma (AITL) -a subtype of PTCL -treated with belinostat.These cases illustrate the challenges of managing AITL, with belinostat achieving disease control for 13 and 14 months, respectively.Despite eventual progression and its related complications, belinostat demonstrated good tolerability and the potential to prolong survival and improve quality of life.These clinical results illustrate the complexity of treating high-risk PTCL patients and highlight the importance of personalized treatment strategies.In addition, those cases underline the role of vigilant monitoring and genetic profiling in optimizing therapeutic decisions.Belinostat represents a valuable option for patients with r/r AITL, potentially improving their quality of life and disease control.Further studies are needed to refine its role within treatment protocols for this challenging hematological malignancy.