chidamide + etoposide + methylprednisolone

Chidamide + etoposide + methylprednisolone is a combination regimen used primarily in the treatment of hemophagocytic lymphohistiocytosis (HLH) and investigated for other hematologic malignancies. Chidamide is a novel, selective histone deacetylase inhibitor (HDACi) that modulates gene expression by inhibiting HDAC enzymes, leading to cell cycle arrest, apoptosis, and immune modulation. Etoposide is a topoisomerase II inhibitor that induces DNA strand breaks and apoptosis in rapidly dividing cells. Methylprednisolone is a synthetic glucocorticoid with potent anti-inflammatory and immunosuppressive effects; it inhibits multiple inflammatory cytokines and suppresses immune cell activation. The combination leverages synergistic mechanisms—chidamide sensitizes malignant or hyperactive immune cells to etoposide-induced cytotoxicity while methylprednisolone dampens excessive inflammation[2][3]. This regimen has shown promising efficacy with manageable safety in adult HLH patients[2][3].