Chidamide: Exploration of maintenance therapy for patients with DLBCL with HBV infection

Hepatitis B virus (HBV) infection worsens the prognosis of patients with diffuse large B-cell lymphoma (DLBCL), possibly through epigenetic mechanisms. We conducted a prospective, single-arm, open-label clinical trial (NCT04661943) to evaluate the efficacy and safety of chidamide maintenance therapy in patients with HBV+ DLBCL who achieved complete or partial response after first-line treatment. Seventy patients with HBV+ were enrolled, including 30 receiving chidamide (20 mg twice weekly for two years) and 40 controls who declined treatment, with a propensity score-matched HBV- cohort for comparison. Chidamide maintenance significantly improved progression-free survival (<i>p</i> = 0.035) and overall survival (<i>p</i> = 0.041) in patients with HBV+ and was well tolerated without unexpected adverse events. These findings indicate that chidamide maintenance therapy can overcome HBV-associated poor prognosis in DLBCL and may serve as an effective maintenance strategy for this high-risk group.