ClinicalTrials.gg
Not yet recruitingNCT07774377CHI-HSCTUpdated Aug 19, 2026

Chidamide Maintenance to Prevent Relapse After Allogeneic Hematopoietic Stem Cell Transplantation in Acute T-Lymphoblastic Leukemia/Lymphoma

A Phase 3 interventional study of Chidamide and Control Group in T-Cell Acute Lymphoblastic Leukemia and T-Cell Lymphoblastic Lymphoma, sponsored by First Affiliated Hospital of Zhejiang University. Not yet recruiting. Open to participants aged 14 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-08-19.

Sponsored by First Affiliated Hospital of Zhejiang University · Phase 3, Interventional, and Prevention

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Phase
Phase 3
Study type
Interventional
Enrollment
132
Allocation
Randomized
Ages
14 Years to 70 Years
Sex
All
01

Study summary

This study evaluates whether chidamide maintenance therapy can effectively reduce the risk of relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with high-risk T-cell acute lymphoblastic leukemia or lymphoblastic lymphoma (T-ALL/LBL). Chidamide is an oral selective histone deacetylase inhibitor (HDACi) with dual anti-tumor and immunomodulatory effects.

Participants will be randomized in a 1:1 ratio to receive either chidamide maintenance for up to 24 months or standard follow-up without maintenance. The primary endpoint is relapse-free survival (RFS). Key secondary endpoints include cumulative incidence of relapse (CIR), overall survival (OS), non-relapse mortality (NRM), incidence and severity of graft-versus-host disease (GVHD), safety profile, and patient-reported outcomes (PROs).

This multicenter, open-label, randomized controlled trial aims to provide high-level evidence on the efficacy and safety of chidamide as a post-transplant maintenance strategy. Approximately 132 patients will be enrolled across 6 transplant centers in China.

Read the detailed description

Study Design:

This is a prospective, multicenter, open-label, randomized, parallel-group, superiority clinical trial. A total of 132 patients with ETP-phenotype T-ALL/LBL who have achieved complete remission after allo-HSCT will be enrolled.

Intervention:

Chidamide Group: Oral chidamide 10 mg twice weekly (BIW) starting at Day +30 to +100 post-transplant. Treatment cycles are 4 weeks each, for a total of 26 cycles (approximately 24 months). Dose may be escalated to 20 mg BIW in case of MRD positivity.

Control Group: Standard follow-up without maintenance therapy. Regular assessments are performed per the same schedule as the treatment group.

Study Assessments:

Efficacy: Relapse-free survival (RFS), cumulative incidence of relapse (CIR), overall survival (OS), non-relapse mortality (NRM).

Safety: Adverse events graded by NCI-CTCAE v6.0, including hematologic toxicity, infections, and transplant-related complications (TA-TMA, VOD/SOS, etc.).

GVHD: Acute GVHD graded per MAGIC criteria, chronic GVHD per NIH 2014/2020 criteria.

Exploratory: Minimal/measurable residual disease (MRD) dynamics by multi-parameter flow cytometry (MFC) or qPCR/NGS; immune reconstitution (T/B/NK/Treg subsets); cytokine/chemokine profiling; patient-reported outcomes (EQ-5D-5L, FACT-BMT); and health economic evaluation.

Follow-up:

Patients will be followed for at least 24 months after the last patient is enrolled. The total study duration is expected to be approximately 4 years.

Statistical Analysis:

The primary analysis will be performed on the modified intention-to-treat (mITT) population. RFS will be estimated using the Kaplan-Meier method and compared by log-rank test. A Cox proportional hazards model will be used to estimate hazard ratios (HR) with 95% confidence intervals (CI). For competing risk events (e.g., NRM for CIR), the Fine-Gray subdistribution hazard model will be applied. Sensitivity analyses will be conducted to assess robustness.

Sample Size:

Based on Schoenfeld's formula for log-rank test, assuming a 2-year RFS of 55% in the control group and 75% in the chidamide group (HR ≈ 0.48), with a two-sided alpha of 0.05, power of 80%, and 1:1 allocation, approximately 59 events are required. Accounting for a 5% dropout rate, the total sample size is 132 patients (66 per group).

02

Conditions studied

  • T-Cell Acute Lymphoblastic Leukemia
  • T-Cell Lymphoblastic Lymphoma

Keywords

  • Chidamide
  • T-cell acute lymphoblastic leukemia
  • T-cell lymphoblastic lymphoma
03

In context

Precursor T-Cell Lymphoblastic Leukemia-Lymphoma

420 studies on the registry are indexed under Precursor T-Cell Lymphoblastic Leukemia-Lymphoma; 76 are open to participants now.

This study's planned enrollment of 132 is above the median of 30 across 322 interventional studies indexed under Precursor T-Cell Lymphoblastic Leukemia-Lymphoma.

Browse Precursor T-Cell Lymphoblastic Leukemia-Lymphoma studies →

Lead sponsor

First Affiliated Hospital of Zhejiang University is the lead sponsor of 263 studies on the registry; 144 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
14 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Age 14-70 years (inclusive).
  2. Confirmed diagnosis of T-cell acute lymphoblastic leukemia (T-ALL) or T-cell lymphoblastic lymphoma (T-LBL) according to the 2016 WHO classification, with an early T-cell precursor (ETP) phenotype defined by immunophenotypic criteria: CD1a-, CD8-, CD5 weak, with expression of one or more myeloid/stem cell markers (e.g., CD34, CD117, HLA-DR, CD13, CD33, CD11b, or CD65).
  3. Have undergone hematopoietic stem cell transplantation (allo-HSCT) and achieved complete remission (CR/CRh/CRi) with full donor chimerism (≥95% by STR or equivalent method).
  4. (ECOG) performance status 0-2.
  5. Adequate organ function:

    • ≥60 mL/min (Cockcroft-Gault).
    • and ALT ≤3×; total ≤2×ULN (≤3×ULN for Gilbert's syndrome).
    • (LVEF) ≥50% by echocardiography.
  6. >8 weeks.
  7. Willing and able to provide written and comply with study procedures.
  8. For women of : negative serum/urine pregnancy test at baseline; and agreement to use highly effective during treatment and for at least 6 months after the last dose.

Exclusion criteria

Exclusion Criteria:

  1. Evidence of relapse or disease progression at screening or baseline.
  2. Persistent significant myelosuppression (ANC \<1.0×10⁹/L or \<25×10⁹/L within 7 days without transfusion support) unrelated to reversible causes.
  3. Active grade 3-4 acute , or acute GVHD requiring systemic ≥0.5 mg/kg/day prednisone equivalent to control; or active moderate-severe chronic GVHD not well controlled by standard therapy.
  4. Active disease requiring systemic .
  5. cardiovascular disease: uncontrolled arrhythmia, prolongation >470 ms (males) or >480 ms (females), uncontrolled hypertension ≥160/100 mmHg, class III-IV heart failure, or acute myocardial infarction/unstable angina within 6 months.
  6. Uncontrolled infections or other severe medical conditions that would increase study risk.
  7. Uncontrolled chronic viral infections: positive; (HBsAg positive with HBV-DNA > or not on antiviral therapy); (anti-HCV positive with HCV RNA >ULN or not on antiviral therapy).
  8. Pregnancy or breastfeeding, or unwillingness to use effective .
  9. Gastrointestinal disorders affecting oral drug absorption.
  10. Inability to understand or comply with study requirements.
  11. Use of other HDAC inhibitors or anticancer agents within 14 days prior to randomization; use of strong CYP inducers/inhibitors that may significantly alter chidamide exposure; or within 4 weeks before baseline.
Terms in these criteria, in plain language(24)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

GVHD (graft-versus-host disease)

After a transplant from a donor, the donor’s immune cells attack the recipient’s body, often the skin, gut or liver.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

05

Study design

Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
132 participants (estimated)

Study arms

  • Experimental
    Chidamide Group

    Oral chidamide 10 mg twice weekly (BIW) starting at Day +30 to +100 post-transplant. Treatment cycles are 4 weeks each, for a total of 26 cycles (approximately 24 months). Dose may be escalated to 20 mg BIW in case of MRD positivity.

    Drug: Chidamide

  • Sham comparator
    Control Group

    Standard follow-up without maintenance therapy. Regular assessments are performed per the same schedule as the treatment group.

    Other: Control Group

Interventions

  • Oral chidamide 10 mg twice weekly (BIW) starting at Day +30 to +100 post-transplant. Treatment cycles are 4 weeks each, for a total of 26 cycles (approximately 24 months). Dose may be escalated to 20 mg BIW in case of MRD positivity.

  • OtherControl Group

    Standard follow-up without maintenance therapy. Regular assessments are performed per the same schedule as the treatment group.

06

What researchers measure

Primary outcomes

  1. Relapse-Free Survival (RFS)

    Time from randomization to the first occurrence of either: (1) disease relapse/progression confirmed by morphology, imaging, or MRD criteria, or (2) death from any cause. Donor lymphocyte infusion (DLI) triggered by MRD elevation is counted as a relapse event. Assessed by Kaplan-Meier method.

    Time frame: From randomization to event, assessed up to 2 years

Secondary outcomes

  1. Cumulative Incidence of Relapse (CIR)

    Time from randomization to first relapse/progression, treating non-relapse mortality (NRM) as a competing risk. Analyzed using the Fine-Gray subdistribution hazard model.

    Time frame: From randomization to event, assessed up to 2 years

  2. Overall Survival (OS)

    Time from randomization to death from any cause. Assessed by Kaplan-Meier method.

    Time frame: From randomization to event, assessed up to 2 years

  3. Non-Relapse Mortality (NRM)

    Time from randomization to death without prior relapse/progression, treating relapse as a competing risk. Analyzed using the Fine-Gray model.

    Time frame: From randomization to event, assessed up to 2 years

  4. Cumulative Incidence of Graft-versus-Host Disease (GVHD)

    Cumulative incidence of acute GVHD (graded per MAGIC criteria) and chronic GVHD (graded per NIH 2014/2020 criteria), with death as a competing risk.

    Time frame: From randomization to event, assessed up to 2 years

  5. Incidence of Adverse Events (AEs)

    Incidence of all adverse events, treatment-emergent AEs, serious AEs (SAEs), and adverse events of special interest (AESIs, including TA-TMA, VOD/SOS, and CMV/EBV reactivation), graded by NCI-CTCAE v6.0.

    Time frame: From randomization until 28 days after last dose.

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: Yes — De-identified individual participant data (IPD) for the primary and key secondary outcomes, along with the data dictionary and statistical analysis scripts (R code), will be made available upon reasonable request. Data sharing will begin 6 to 12 months after publication of the primary results. Requests must include a scientifically valid research proposal and documented ethics approval. A data use agreement will be required. All shared data will be de-identified to protect participant privacy. Requests should be directed to the principal investigator at the Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine.

Supporting information: Study protocol

Time frame: IPD and supporting information will be available starting 6 months after publication of the primary results and will remain accessible for a period of 12 months.

Access criteria: Access will be granted to researchers who submit a methodologically sound research proposal with a clear analysis plan and documented ethics approval from their institution. The request must be directed to the principal investigator. Approved applicants will receive de-identified individual participant data (IPD), a data dictionary with variable definitions, and fully annotated statistical analysis scripts (R code) to enable replication of the primary and key secondary analyses.

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for Aug 2026; primary completion for Aug 2028, 24 months later.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 10, 2026
First posted
Aug 19, 2026
StartEst.
Aug 15, 2026
Primary completionEst.
Aug 15, 2028
CompletionEst.
Aug 15, 2029
Last update
Aug 19, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 19, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07774377
Responsible party
Yanmin Zhao (professor, First Affiliated Hospital of Zhejiang University) — Principal investigator
First posted
Aug 19, 2026
Start date
Aug 15, 2026 (estimated)
Primary completion
Aug 15, 2028 (estimated)
Completion
Aug 15, 2029 (estimated)
Last update
Aug 19, 2026

Study contacts

Yanmin Zhao, MD
Contact
yanminzhao@zju.edu.com
057187236706
Yanmin Zhao, MD
principal investigator · First Affiliated Hospital of Zhejiang University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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