Lisocabtagene Maraleucel for Richter's Transformation-A Case Series

Richter's transformation (RT) from chronic lymphocytic leukemia (CLL) to lymphoma carries poor prognosis. This case series examines the efficacy of lisocabtagene maraleucel (liso-cel) in six RT patients, highlighting the impact of concurrent ibrutinib therapy.

Six patients were with RT who received liso-cel from were included in this single institution case series. Clinical data related to efficacy, safety, CAR-T expansion kinetics, and measurable residual disease were collected.

The best overall response was 83.3%. The four patients who received ibrutinib concurrent with liso-cel therapy continue to show MRD-negative complete response till date. None experienced severe (grade 3+) cytokine release syndrome while 1 had severe (grade 3+) immune-effector cell-associated neurotoxicity syndrome (ICANS). All patients were noted to have in vivo CAR expansion.

This series of real cases suggests liso-cel with concurrent ibrutinib may be a promising treatment for RT, warranting further exploration.