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Chimeric antigen receptor T-cell therapy for relapsed mantle cell lymphoma: real-world experience from a single tertiary care center

Bone Marrow Transplantation volume 57, pages 1010–1012 (2022)Cite this article

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Mantle cell lymphoma (MCL) is a rare type of B-cell lymphoma affecting predominantly male patients with a median age of 68 years at diagnosis. While complete remission is frequently achieved with first-line treatment, the majority of patients will ultimately relapse, with a usually aggressive further course of the disease. The use of cytarabine-comprising induction chemotherapy and subsequent autologous stem cell transplantation (ASCT), of rituximab maintenance, and of Bruton’s tyrosine kinase (BTK) inhibitors has substantially improved outcome [1,2,3]. However, the outcome of patients relapsing after BTK inhibitors is dismal, with low response rates and short duration of response to salvage therapy [4].

The phase II ZUMA-2 trial has reported promising results with CD19 directed chimeric antigen receptor T-cell (CAR-T) therapy in MCL patients relapsing after BTK inhibitors, with an overall response rate (ORR) of 93% and durable remissions in more than 60% of responding patients. Moreover, treatment was well tolerated with cytokine-release syndrome (CRS) and immune-cell associated neurotoxicity syndrome (ICANS) grade ≥3 in 15% and 31% of patients, respectively [5]. CAR-T cell treatment has also shown encouraging responses in other relapsed/refractory B-cell malignancies, including DLBCL [6] and acute B-cell lymphoblastic leukemia. Remarkably, real-world reports have reproduced similar efficacy and safety data as observed in the pivotal trials [7, 8]. This is noteworthy since real-world MCL patients commonly tend to be older, more pretreated, and may often not meet trial eligibility criteria due to comorbidities [9].

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Data supporting the findings of this investigation are available from the corresponding author upon request.

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Authors and Affiliations

  1. Department of Medical Oncology, Inselspital, Bern University Hospital, Bern, Switzerland

    Alexander D. Heini, Marie-Noëlle Kronig, Urban Novak & Thomas Pabst

  2. Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, Bern, Switzerland

    Ulrike Bacher, Gertrud Wiedemann, Sacha Zeerleder, Behrouz Mansouri Taleghani & Michael Daskalakis

  3. Department for Biomedical Research, University of Bern, Bern, Switzerland

    Thomas Pabst

Authors
  1. Alexander D. Heini
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  2. Ulrike Bacher
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  3. Marie-Noëlle Kronig
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  4. Gertrud Wiedemann
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  5. Urban Novak
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  7. Behrouz Mansouri Taleghani
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  8. Michael Daskalakis
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  9. Thomas Pabst
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All authors were involved in the preparation of the manuscript.

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Correspondence to Thomas Pabst.

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Heini, A.D., Bacher, U., Kronig, MN. et al. Chimeric antigen receptor T-cell therapy for relapsed mantle cell lymphoma: real-world experience from a single tertiary care center. Bone Marrow Transplant 57, 1010–1012 (2022). https://doi.org/10.1038/s41409-022-01658-x

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