[CAR-T cell therapy in a patient with relapsed/refractory mantle cell lymphoma]

Mantle cell lymphoma (MCL) is one of the rarest forms of non-Hodgkin's lymphoma that mainly affects adults around 65 years of age or older, and is diagnosed when the disease has already reached a fairly advanced stage. Partly for this reason, but mainly because of the very characteristics of this rare form of lymphoma, the prognosis is often poor. In most cases, the disease recurs after a period of remission achieved with I-line. In the past decade, BTK inhibitors have become a mainstay of therapy for patients with relapsed/refractory mantle cell lymphoma. Although BTK inhibitors have improved the prognosis of relapsed/refractory mantle cell lymphoma, treatment options for patients who experience progression during or after BTK inhibitors remain limited. In this context, the development of anti-CD19 CAR T-cell therapy represents an important advance in the treatment of patients with chemorefractory MCL.

We present the case of a 65-year-old man with diagnosis Mantle cell lymphoma MIPI intermediate risk, positive history only for hypertension, in disease progression during II-line therapy with Ibrutinib undertaken for relapse after of I-line polychemotherapy and consolidation with autologous HSC transplantation.

The availability of this first cell therapy for relapsed or refractory mantle cell lymphoma provides an important option for patients. At present, treatment options for these patients, whose disease progresses after initial therapies, are almost nil. Thus, there is a felt need for new treatment options. The high response rates observed in the registrational study and confirmed by real-life data support the potential of KTE-X19 as an effective therapy for patients with relapsed or refractory mantle cell lymphoma, with a manageable safety profile.