Table 1.
Treatment timescales.
| Start time | Therapy | Number of cycles | Time for repeat CT/PET | Effect | |
|---|---|---|---|---|---|
| 1st | 2019/7/19 | R-EPOCH: rituximab, etoposide, vincristine, cyclophosphamide, doxorubicin, and dexamethasone | 1 | 2019/8/8 (CT) | Stable disease |
| 2nd | 2019/8/15 | R-EPOCH + lenalidomide (25 mg d1-7) + ibrutinib (420 mg once a day) | 1 | 2019/9/4 (PET) | Progressive metabolic disease |
| 3rd | 2019/9/5 | GDP (gemcitabine, DDP, and dexamethasone) + Sintilimab (200 mg d1) + Decitabine (10 mg d1-5) | 1 | 2019/9/17 (CT) | Stable disease |
| 4th | 2019/9/29 | Sintilimab (200 mg, iv. d1) + Decitabine (10 mg, iv, d1-5) + Chidamide (20 mg, po, twice a week) | 3. | 2019/10/17 (PET) | Partial metabolic response and >90% shrinkage of mass |
| 2019/10/22 | |||||
| 2019/11/12 | 2019/11/26 (PET) | Progressive metabolic disease | |||
| 5th | 2019/11/29 | Radiotherapy (50 Gy) + Sintilimab (200 mg d1) + Chidamide (20 mg twice a week) + venetoclax | 1 | 2020-2-5 (PET) | Progressive metabolic disease |
| 2020/2/10 | Syngeneic stem cell transplantation | 2020-3-25 (PET) | Complete metabolic response |
CT, computed tomography; PET, positron emission tomography. Response assessment was made according to the Lugano classification [17]: Stable disease: <50% decrease from baseline in SPD of up to 6 dominant, measurable nodes, and extranodal sites; no criteria for progressive disease are met. Progressive metabolic disease: PET-CT Score 4 or 5 with an increase in intensity of uptake from baseline and/or new foci consistent with lymphoma at interim or end-of-treatment assessment. Partial metabolic response: PET-CT score 4 or 5 with reduced uptake compared with baseline and residual mass(es) of any size. Complete metabolic response: score 1, 2, or 3 with or without a residual mass on 5 PET-CT score.